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Individual

JACQUELINE MARIE SIMMONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1914 POST RD, APT 211, MADISON, WI 53713-4308
(608) 663-9134
Mailing address
401 OAKLAND AVE, SUN PRAIRIE, WI 53590-1613
(608) 825-6469

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38295600
WI
Enumeration date
05/26/2007
Last updated
07/09/2007
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