Individual
JESSICA TOMTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9532 E 16 FRONTAGE RD, STE. 100, ONALASKA, WI 54650-6739
(608) 783-0506
Mailing address
9532 E 16 FRONTAGE RD, STE 100, ONALASKA, WI 54650-6739
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
30654631
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003150004
—
WI
Enumeration date
03/24/2016
Last updated
03/24/2016
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