Look up the most recent NPI and PECOS records

Jackie Julie Budynek

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2901 W Kinnickinnic River Pkwy Ste 507, Milwaukee, WI 53215-3660

PECOS Enrollment

This provider is enrolled in PECOS as JACQUELINE BUDYNEK.

Based on the most recent information from CMS, provider Jackie Julie Budynek is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1619153384
Provider Type
Individual
Full Name
Budynek, Jackie Julie
Credential
RN, APNP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/12/2008
Last Updated
11/29/2021

Contact Information

Practice Location

2901 W Kinnickinnic River Pkwy Ste 507, Milwaukee, WI 53215-3660

(414) 649-3780

(414) 649-3794

Mailing Location

3301 W Forest Home Ave, Milwaukee, WI 53215-2843

(414) 389-2377

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 4212-033 Wisconsin
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License 155-059-30 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 100036033	Description Medicaid	Issuer Unlisted Wisconsin

Jackie Julie Budynek

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Hasse, Bethany

Camosy, Nicole

Carman, Emily

Johnson, Pamela S

Szudrowitz Warner, Danielle K

Hays, Sara R

Hourani, Lama R

Moreno, Samantha

Diaz, Jordan A

Eilers, Sarah