Provider Demographics
NPI:1508896572
Name:MCCOMMONS, JENNIFER M (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:MCCOMMONS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3085 MEADOWLARK LN
Mailing Address - Street 2:STE 20
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-2656
Mailing Address - Country:US
Mailing Address - Phone:414-988-6350
Mailing Address - Fax:414-988-6355
Practice Address - Street 1:3119 WOODMAN DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:WI
Practice Address - Zip Code:54720-2668
Practice Address - Country:US
Practice Address - Phone:888-277-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI998 023363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S84637Medicare UPIN