Individual
JOLIE A DILLABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
104 GEORGE ST, PEWAUKEE, WI 53072-3504
(262) 691-1299
Mailing address
W399 CTY HWY L, EAST TROY, WI 53120
(262) 490-7997
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350-38-900
—
WI
Enumeration date
09/05/2007
Last updated
10/29/2007
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