Individual
KYLIE JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
990 PLANK RD, MENASHA, WI 54952-2936
(701) 412-7415
Mailing address
990 PLANK RD, MENASHA, WI 54952-2936
(701) 412-7415
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
604-49
WI
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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