Individual
JACKLINE JERUSA AYUKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
AUREUS MEDICAL GROUP, 13609 CALIFORNIA ST., OMAHA, NE 68154-5260
(402) 891-1118
Mailing address
4447 COVENTRY PKWY, FORT WAYNE, IN 46804-7105
(321) 444-3325
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
28260037A
IN
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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