Individual
JACQUSIE LAVERN TRUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6105 W SHERIDAN AVE, MILWAUKEE, WI 53218-3146
(262) 336-0056
(262) 336-0065
Mailing address
6105 W SHERIDAN AVE, MILWAUKEE, WI 53218-3146
(262) 336-0065
(262) 336-0065
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
251B00000X
WI
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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