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Contact Information

JESSICA H ALTIS, PA-C
11211 W LINCOLN AVE
LINCOLN AVENUE CLINIC
WEST ALLIS, WI53227-1035
 Phone: 414-955-5900
 Fax: 414-327-7639
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JESSICA H ALTIS · (Female)

NPI # 1841587029
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/07/2011
Last updated 02/15/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 278623
  • WI Medicaid 1841587029
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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