Provider Demographics
NPI:1356517122
Name:BOSLER, JAYME SUSAN
Entity type:Individual
Prefix:
First Name:JAYME
Middle Name:SUSAN
Last Name:BOSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAYME
Other - Middle Name:SUSAN
Other - Last Name:GILGENBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W129N7055 NORTHFIELD DR
Mailing Address - Street 2:REPRODUCTIVE ENDOCRINOLOGY/INFERTILITY
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-0538
Mailing Address - Country:US
Mailing Address - Phone:262-253-5400
Mailing Address - Fax:
Practice Address - Street 1:W129N7055 NORTHFIELD DR
Practice Address - Street 2:REPRODUCTIVE ENDOCRINOLOGY/INFERTILITY
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-0538
Practice Address - Country:US
Practice Address - Phone:262-253-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63941207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1356517122Medicaid