Individual
MISS JACQUELINE DENISE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8257 N 51ST ST, BROWN DEER, WI 53223-3512
(414) 446-5522
Mailing address
8257 N 51ST ST, BROWN DEER, WI 53223-3512
(414) 446-5522
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309489-031
WI
Other
Enumeration date
02/06/2009
Last updated
02/06/2009
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