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Individual

GABRIELLE KAKUSKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1312 BARBERRY DR STE 110, JANESVILLE, WI 53545-0589
(608) 758-1944
Mailing address
1312 BARBERRY DR STE 110, JANESVILLE, WI 53545-0589
(608) 758-1944

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
264386-30
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1578234902
WI
Enumeration date
07/25/2022
Last updated
07/25/2022
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