Individual
JACKIE JOACHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
221 E SUNSET DR, WAUKESHA, WI 53186
(866) 825-3227
(484) 450-2617
Mailing address
161 WASHINGTON ST, EIGHT TOWER BRIDGE STE 1400, CONSHOHOCKEN, PA 19428
(866) 825-3227
(484) 450-2617
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3175
WI
363LF0000X
Family Nurse Practitioner
Primary
3175
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3175
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3175
APNP LICENSE
WI
Enumeration date
09/21/2007
Last updated
05/04/2020
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