Provider Demographics
NPI:1023220332
Name:TISCHLER, JESSICA K (MSN-CNM)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:K
Last Name:TISCHLER
Suffix:
Gender:F
Credentials:MSN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 W PARADISE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-9795
Mailing Address - Country:US
Mailing Address - Phone:262-334-3451
Mailing Address - Fax:262-306-2964
Practice Address - Street 1:402 W SUMNER ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-1400
Practice Address - Country:US
Practice Address - Phone:262-670-4824
Practice Address - Fax:262-306-2964
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI137925-030367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife