Provider Demographics
NPI:1275795940
Name:TIMMERMAN, JOANNE R (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:R
Last Name:TIMMERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:R
Other - Last Name:SCHERWINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7721 W GRANT ST
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53219-1836
Mailing Address - Country:US
Mailing Address - Phone:715-741-0414
Mailing Address - Fax:
Practice Address - Street 1:1504 MADISON AVE
Practice Address - Street 2:
Practice Address - City:FORT ATKINSON
Practice Address - State:WI
Practice Address - Zip Code:53538-3100
Practice Address - Country:US
Practice Address - Phone:920-563-7888
Practice Address - Fax:920-563-7741
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2263363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant