Individual
JENNIFER JUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1817 104TH ST, LOT 122, PLEASANT PRAIRIE, WI 53158-6214
(262) 577-4139
Mailing address
1817 104TH ST, LOT 122, PLEASANT PRAIRIE, WI 53158-6214
(262) 577-4139
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305835-31
WI
Other
Enumeration date
10/01/2013
Last updated
10/01/2013
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