Provider Demographics
NPI:1821105370
Name:LEVINE, JANE E (NP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:E
Last Name:LEVINE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-647-6326
Mailing Address - Fax:414-671-8860
Practice Address - Street 1:1136 WESTOWNE DR
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2175
Practice Address - Country:US
Practice Address - Phone:920-720-8130
Practice Address - Fax:920-720-8131
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI81355-030363L00000X
WI1092-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner