Gundacker, Jesse

Gundacker, Jesse is an individual health care provider with primary practice located at 1541 Annex Rd , Jefferson WI 53549-9803. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Gundacker, Jesse can be contacted via phone (920) 723-1088.

Contact Information

Primary practice address
1541 Annex Rd Jefferson WI 53549-9803
Phone: (920) 723-1088
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1578288288
LBN Legal business name Gundacker, Jesse
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2022
Last updated Oct 28th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578288288 NPPES
Wisconsin MEDICAID 518

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