Individual
MS. JO ANN JESCHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1500 16TH AVE, MENOMINEE, MI 49858-2650
(906) 864-4474
Mailing address
1500 16TH AVE, MENOMINEE, MI 49858-2650
(906) 864-4474
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38327700
MEDICAID PROVIDER
WI
Enumeration date
10/19/2007
Last updated
10/19/2007
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