Provider Demographics
NPI:1134447550
Name:DARLING, JESSICA M (DO)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:M
Last Name:DARLING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:M
Other - Last Name:PREMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:112 HELEN ST.
Mailing Address - Street 2:
Mailing Address - City:SAUK CITY
Mailing Address - State:WI
Mailing Address - Zip Code:53583-1101
Mailing Address - Country:US
Mailing Address - Phone:608-643-3351
Mailing Address - Fax:608-643-3621
Practice Address - Street 1:112 HELEN ST.
Practice Address - Street 2:
Practice Address - City:SAUK CITY
Practice Address - State:WI
Practice Address - Zip Code:53583-1101
Practice Address - Country:US
Practice Address - Phone:608-643-3351
Practice Address - Fax:608-643-3621
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60949-21207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1134447550Medicaid
WI1134447550Medicaid