Individual
JACKIE MAE MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 775-3375
Mailing address
17208 KENDALL AVE, NORWALK, WI 54648-7002
(608) 633-5384
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
16966-33
WI
Other
Enumeration date
06/25/2025
Last updated
07/30/2025
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