Individual
JENNIFER A LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1140 HARRISON ST, KAUKAUNA, WI 54130-1133
(920) 636-8433
Mailing address
1140 HARRISON ST, KAUKAUNA, WI 54130-1133
(920) 636-8433
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311789031
WI
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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