Individual
JACQUELINE ANN OTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PENDING
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(920) 303-8700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10085
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099992
—
WI
Enumeration date
01/09/2020
Last updated
07/11/2023
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