Provider Demographics
NPI:1386965804
Name:AHRENS, JACELYN A (AAS)
Entity type:Individual
Prefix:
First Name:JACELYN
Middle Name:A
Last Name:AHRENS
Suffix:
Gender:F
Credentials:AAS
Other - Prefix:
Other - First Name:JACELYN
Other - Middle Name:A
Other - Last Name:HOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AAS
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC ORTHOPAEDIC SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-337-7300
Mailing Address - Fax:414-337-7337
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC ORTHOPAEDIC SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-337-7300
Practice Address - Fax:414-337-7337
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant