Provider Demographics
NPI:1679539589
Name:SCHOENING, JENNIFER L (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:SCHOENING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:THIMMESCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:305 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:KAUKAUNA
Mailing Address - State:WI
Mailing Address - Zip Code:54130-2865
Mailing Address - Country:US
Mailing Address - Phone:920-766-4656
Mailing Address - Fax:920-766-4659
Practice Address - Street 1:305 E 12TH ST
Practice Address - Street 2:
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-2865
Practice Address - Country:US
Practice Address - Phone:920-766-4656
Practice Address - Fax:920-766-4659
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0040242207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32551500Medicaid
WI32551500Medicaid
WIH05707Medicare UPIN