Jill Negrete
Individual provider Active NPI Speech-Language Pathologist · Cushing, WI
NPI 1144488669 · NPPES record last updated Mar 28, 2013
Key facts
- NPI
- 1144488669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 3401-154 (WI)
- Practice address
- 2395 250TH Ave.
Cushing, WI 54006-1234 - Phone
- (715) 648-5040
- NPI assigned
- May 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3401-154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8324 | MN | |
| Speech-Language Pathologist | 235Z00000X | 3401-154 | WI | Yes |
Addresses
Primary practice location
2395 250TH Ave.
Cushing, WI 54006-1234
Mailing address
2395 250TH Ave.
Cushing, WI 54006-1234
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144488669 | Medicaid | WI |
Other providers in Cushing, WI
All providers in Cushing, WI · Speech-Language Pathologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.