Provider Demographics
NPI:1558793067
Name:DUERR, JENNIFER KERI (RN BSN CPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KERI
Last Name:DUERR
Suffix:
Gender:F
Credentials:RN BSN CPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3837 N 86TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-2831
Mailing Address - Country:US
Mailing Address - Phone:414-526-3910
Mailing Address - Fax:
Practice Address - Street 1:3837 N 86TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-2831
Practice Address - Country:US
Practice Address - Phone:414-526-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI153383-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse