Individual
KATIE JEAN DES JARDINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 E NORTHLAND AVE STE B, APPLETON, WI 54911-8582
(920) 731-1999
(920) 731-3729
Mailing address
1301 E NORTHLAND AVE STE B, APPLETON, WI 54911-8582
(920) 731-1999
(920) 731-3729
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
247937-30
WI
2255A2300X
Athletic Trainer
1922-39
WI
363L00000X
Nurse Practitioner
Primary
14228-33
WI
Other
Enumeration date
10/20/2015
Last updated
02/27/2025
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