Gouge, Jacqueline A
Gouge, Jacqueline A is an individual health care provider with primary practice located at 2741 Roosevelt Rd , Marinette WI 54143-3833. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Gouge, Jacqueline A can be contacted via phone (715) 732-1392.Contact Information
Primary practice address
2741 Roosevelt Rd
Marinette WI 54143-3833
Phone: (715) 732-1392
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 5222-33 | Wisconsin |
Profile Details
| NPI number | 1982943494 |
|---|---|
| LBN Legal business name | Gouge, Jacqueline A |
| Credentials | APNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 4th, 2013 |
| Last updated | Mar 19th, 2014 - about 10 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 | 1982943494 | NPPES |
| Michigan | Other | 4704302472 | MICHIGAN LICENSE |
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