Individual
JENNIFER N SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
608 WESTWYND CT, MAZOMANIE, WI 53560-9352
(870) 718-7795
Mailing address
608 WESTWYND CT, MAZOMANIE, WI 53560-9352
(870) 718-7795
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
174871-030
WI
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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