Provider Demographics
NPI:1235173030
Name:MCSWEENEY, JANE J (ARNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:J
Last Name:MCSWEENEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 W NORTH AVE
Mailing Address - Street 2:CHILD DEVELOPMENT CENTER OF CHW
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4977
Mailing Address - Country:US
Mailing Address - Phone:262-432-6600
Mailing Address - Fax:262-432-6604
Practice Address - Street 1:13800 W NORTH AVE
Practice Address - Street 2:CHILD DEVELOPMENT CENTER OF CHW
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4977
Practice Address - Country:US
Practice Address - Phone:262-432-6600
Practice Address - Fax:262-432-6604
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1792202363L00000X
WI200280363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1235173030Medicaid
FLE1743YMedicare ID - Type Unspecified
WI1235173030Medicaid