Individual
JACKIE L SELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1226 SCHOOL ST, SUN PRAIRIE, WI 53590-4475
(815) 914-1769
Mailing address
1226 SCHOOL ST, SUN PRAIRIE, WI 53590-4475
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8486
WI
363LA2200X
Adult Health Nurse Practitioner
8486-33
WI
Other
Enumeration date
03/12/2019
Last updated
09/07/2022
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