Provider Demographics
NPI:1932500808
Name:DOERFER, JENNIFER GRACE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GRACE
Last Name:DOERFER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:GRACE
Other - Last Name:SCHWARZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:FROEDTERT & MCW FASTCARE
Mailing Address - Street 2:5800 W LAYTON AVE
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4021
Mailing Address - Country:US
Mailing Address - Phone:414-805-9959
Mailing Address - Fax:
Practice Address - Street 1:FROEDTERT & MCW FASTCARE
Practice Address - Street 2:5800 W LAYTON AVE
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4021
Practice Address - Country:US
Practice Address - Phone:414-805-9959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704364760363LF0000X
WI5859-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily