Jessica Nenneman
Individual provider Active NPI Physical Therapy Assistant · Clinton, WI
NPI 1457752396 · NPPES record last updated Sep 10, 2014
Key facts
- NPI
- 1457752396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2240-19 (WI)
- Practice address
- 141 High St
Clinton, WI 53525-9475 - Phone
- (608) 289-7796
- NPI assigned
- Sep 10, 2014
- 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 |
|---|---|---|---|
| 2240-19 | WI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2240-19 | WI | Yes |
Addresses
Primary practice location
141 High St
Clinton, WI 53525-9475
Mailing address
141 High St
Clinton, WI 53525-9475
Phone (608) 289-7796
Other providers in Clinton, WI
- Treasa Hendrickson
- Brooke Johansen
- Heather Lynn Kluck
- Alex Marchillo
- Tina Neisius
- Tejesh N Patel
- Shuler Dental Office, S.C.
- Andrew Frank Shuler
- Susan M Spears
- Vop Clinton LLC
All providers in Clinton, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2014. 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.