Provider Demographics
NPI:1225145741
Name:JESKEWITZ, HOLLY C (APNP)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:C
Last Name:JESKEWITZ
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:CATHERINE
Other - Last Name:JACOBSON
Other - Suffix:
Other - Last Name Type:Doing Business As
Other - Credentials:
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-647-6326
Mailing Address - Fax:414-671-8860
Practice Address - Street 1:4070 EQUESTRIAN RD
Practice Address - Street 2:
Practice Address - City:NEW FRANKEN
Practice Address - State:WI
Practice Address - Zip Code:54229
Practice Address - Country:US
Practice Address - Phone:920-866-6100
Practice Address - Fax:920-866-6180
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI130193-030363L00000X
WI2487-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner