Individual
NICOLE E. JUEDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
2105 E. ENTERPRISE AVE., SUITE 111, APPLETON, WI 54913-7862
(920) 731-6611
(920) 731-6732
Mailing address
2105 E. ENTERPRISE AVE., SUITE 111, APPLETON, WI 54913-7862
(920) 731-6611
(920) 731-6732
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
111971
WI
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111971
NATIONAL BOARD OF SURGICAL TECHNOLOGY AND SURGICAL ASSISTING
—
01
—
140411
NATIONAL BOARD OF SURGICAL TECHNOLOGY AND SURGICAL ASSISTING
—
Enumeration date
03/06/2009
Last updated
11/04/2014
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