Provider Demographics
NPI:1811409485
Name:RYAN - GEIGER, JESSICA A
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:RYAN - GEIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W8903 COUNTY ROAD M
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-9325
Mailing Address - Country:US
Mailing Address - Phone:715-218-5834
Mailing Address - Fax:
Practice Address - Street 1:219 ROSS AVE STE 106
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-6110
Practice Address - Country:US
Practice Address - Phone:715-298-1117
Practice Address - Fax:715-227-8720
Is Sole Proprietor?:No
Enumeration Date:2017-11-03
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8125-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily