Individual
JACQUELINE ANN EVERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
E897 TAMMY TRL, WAUPACA, WI 54981-8008
(920) 810-0561
Mailing address
E897 TAMMY TRL, WAUPACA, WI 54981-8008
(920) 810-0561
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5339-016
WI
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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