Individual
MS. JACQUELYN ANN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
5830 LOCHINVARS TRL, MARSHALL, WI 53559-9720
(608) 655-1487
Mailing address
5830 LOCHINVARS TRL, MARSHALL, WI 53559-9720
(608) 655-1487
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
59578-030
WI
Other
Enumeration date
08/07/2007
Last updated
08/07/2007
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