Jennifer Michele Gates

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

318264-31 Issued in WI

Practice address

W2093 Gary LN
Ixonia, WI 53036-9724

Phone

(920) 253-5625

NPI assigned

Jun 6, 2014

Last updated

Jun 6, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Jennifer Michele Krueger Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402012800000",
    "number": "1376956367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2093 GARY LN",
            "city": "IXONIA",
            "state": "WI",
            "postal_code": "530369724",
            "telephone_number": "920-253-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W2093 GARY LN",
            "city": "IXONIA",
            "state": "WI",
            "postal_code": "530369724",
            "telephone_number": "920-253-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "JENNIFER",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-06",
        "last_updated": "2014-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "318264-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KRUEGER",
            "middle_name": "MICHELE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Lynn Bubnick, RN
• Linda Olson Douglas, MD
• Duffy David Eberhardt
• Kim M Jaeger, LCSW SAC
• Amy L Lauersdorf, LPN
• Kerry Wayne Lynch, PH.D.
• Jessica M Nevermann, MS CCC-SLP
• Alissa Olson, LCSW, CSAC

• Licensed Practical Nurse in Ixonia, WI
• Providers in Ixonia, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.