Individual
JACQUELINE M HERRENBRUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,RCS
Contact information
Practice address
3164 GREENBAY ROAD, PORT WASHINGTON, WI 53074-9772
(262) 284-3679
Mailing address
3164 GREENBAY ROAD, PORT WASHINGTON, WI 53074
(262) 284-3679
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
166949-030
WI
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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