Individual
MRS. AMANDA RENE JAEGER-JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
N845 OAK RIDGE DR, OCONOMOWOC, WI 53066-9593
(920) 355-4200
Mailing address
N845 OAK RIDGE DR, OCONOMOWOC, WI 53066-9593
(920) 355-4200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
129072-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35058400
—
WI
Enumeration date
05/12/2008
Last updated
05/12/2008
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