Individual
JACOB T PFLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-4101
(920) 939-3827
Mailing address
3305 N BALLARD RD STE A, APPLETON, WI 54911-9001
(920) 202-3363
(920) 939-3827
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
189961-30
WI
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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