Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125-067112 | IL |
Y | 208000000X | Pediatrician | 69913 | WI |
N | 2080P0216X | Pediatric Rheumatologist | 69913 | WI |
NPI | 1174904767 |
---|---|
Provider Name | Dr. Jessica L Schnell |
First Address | Milwaukee, WI 53226-4874 |
Second Address | Milwaukee, WI 53226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2015 |
Last Update Date | 06/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174904767 | (05) | WI |