Johnson-Kruse, Jacquelyn Sue
Johnson-Kruse, Jacquelyn Sue is an sole proprietor health care provider with primary practice located at 7114 Hayward Crossing Rd , Arena WI 53503-9317. She recently has only one registered license in Nursing Service Providers / General Practice, which is considered as her primary health care specialty. Johnson-Kruse, Jacquelyn Sue can be contacted via phone (608) 753-2075.Contact Information
Primary practice address
7114 Hayward Crossing Rd
Arena WI 53503-9317
Phone: (608) 753-2075
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / General Practice | 163WG0000X | 163WG0000X | Wisconsin |
Profile Details
| NPI number | 1013122902 |
|---|---|
| LBN Legal business name | Johnson-Kruse, Jacquelyn Sue |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 14th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1013122902 | NPPES |
| Wisconsin | MEDICAID | 3902114320 |
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