Provider Demographics
NPI:1609899954
Name:WAINAINA, JANE NJERI (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:NJERI
Last Name:WAINAINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:N
Other - Last Name:KARANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBCLB
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6850
Mailing Address - Fax:414-805-6851
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6850
Practice Address - Fax:414-805-6851
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036114853207R00000X
WI50540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1609899954Medicaid
WI1609899954Medicaid
WI736012430Medicare PIN