Individual ProviderJessica KuennenPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kinnickinnic River Pkwy Ste 880, Milwaukee, WI 53215-3678(414) 649-3370(800) 326-2250PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Kuennen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1295229805Provider TypeIndividualFull NameKuennen, JessicaGenderFemaleSole ProprietorNoEnumeration Date6/18/2018Last Updated9/3/2024Contact InformationPractice LocationPractice Address2801 W Kinnickinnic River Pkwy Ste 880, Milwaukee, WI 53215-3678Phone(414) 649-3370FaxUnlisted FaxMailing LocationMailing AddressPO Box 735044, Chicago, IL 60673-5044Phone(800) 326-2250FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense4417WisconsinProvider IdentifiersIDDescriptionIssuerID100080142DescriptionMedicaidIssuerUnlistedWisconsinID1295229805DescriptionMedicaidIssuerUnlistedWisconsin