Individual
MRS. JENNA SUE FICKBOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N
Contact information
Practice address
13483 COUNTY ROAD F, GRANTSBURG, WI 54840-7363
(651) 353-5535
Mailing address
13483 COUNTY ROAD F, GRANTSBURG, WI 54840-7363
(651) 353-5535
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L068049-1
MN
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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