Provider Demographics
NPI:1811334501
Name:FUREY, JESSICA ERIN (DO)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ERIN
Last Name:FUREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 N WISCONSIN ST
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-1138
Mailing Address - Country:US
Mailing Address - Phone:262-741-1400
Mailing Address - Fax:262-741-1401
Practice Address - Street 1:839 N WISCONSIN ST
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-1138
Practice Address - Country:US
Practice Address - Phone:262-741-1400
Practice Address - Fax:262-741-1401
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020593207Q00000X
WI66119-21207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine