Individual
JACQUELYN SUE JOHNSON-KRUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
7114 HAYWARD CROSSING RD, ARENA, WI 53503-9317
(608) 753-2075
Mailing address
7114 HAYWARD CROSSING RD, ARENA, WI 53503-9317
(608) 753-2075
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
163WG0000X
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3902114320
—
WI
Enumeration date
05/14/2007
Last updated
07/09/2007
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