Individual
JANELL R JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1981 GREENGROVE ST, KAUKAUNA, WI 54130-3921
(920) 759-4436
Mailing address
3330 E PARIS WAY APT 8, APPLETON, WI 54913-8298
(920) 810-5027
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
218535
WI
164W00000X
Licensed Practical Nurse
311511-031
WI
Other
Enumeration date
10/30/2009
Last updated
09/16/2014
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