Jessica Kupser, BSN RN
Individual provider Active NPI General Practice Registered Nurse · Wales, WI
NPI 1922573773 · NPPES record last updated Oct 9, 2018
Key facts
- NPI
- 1922573773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Registered Nurse 163WG0000X
- License
- 143519-30 (WI)
- Practice address
- 415 Black Earth Rd
Wales, WI 53183-9759 - Phone
- (414) 630-8104
- NPI assigned
- Oct 9, 2018
- 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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143519-30 | WI | MD | General Practice Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | 143519-30 | WI | Yes |
Addresses
Primary practice location
415 Black Earth Rd
Wales, WI 53183-9759
Mailing address
530 Windstone Dr Unit 201
Hartland, WI 53029-1658
Phone (414) 630-8104
Other providers in Wales, WI
- Jack Hoeffleur DDS Inc
- Anne Marie Johnson
- Journeys Occupational Therapy LLC
- Kathleen Ann Kane
- Emily Klik
- Jared Landreman
- Jonathan Luetke
- Laura Martin
- Mary Elizabeth Mascari
- Jennifer Autumn Mastrangelo
All providers in Wales, WI · General Practice Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2018. 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.