Bodden, Jacquelyne Anne
Bodden, Jacquelyne Anne is an individual health care provider with primary practice located at 216 S 3Rd Ave , Wausau WI 54401-4636. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Bodden, Jacquelyne Anne can be contacted via phone (800) 246-5743.Contact Information
Primary practice address
216 S 3Rd Ave
Wausau WI 54401-4636
Phone: (800) 246-5743
Fax: (715) 675-1819
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Women's Health | 363LW0102X | 1476-033 | Wisconsin |
Profile Details
| NPI number | 1841299948 |
|---|---|
| LBN Legal business name | Bodden, Jacquelyne Anne |
| Credentials | MSN RN-C WHNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Apr 1st, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841299948 | NPPES |
| Wisconsin | MEDICAID | 43973600 |
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