Jaclynn Ann Miskulin-Baggesen, RN

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

127497030 Issued in WI

Practice address

2134 Green St
Racine, WI 53402-4569

Phone

(262) 637-3179

Fax

(262) 637-3179

NPI assigned

Jun 26, 2008

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1598927014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 GREEN ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534024569",
            "telephone_number": "262-637-3179",
            "fax_number": "262-637-3179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 GREEN ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534024569",
            "telephone_number": "262-637-3179",
            "fax_number": "262-637-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISKULIN-BAGGESEN",
        "first_name": "JACLYNN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "WI",
            "license": "127497030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN MEDICAID PROVIDER NUMBER",
            "identifier": "38231000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Registered Nurse in Racine, WI
• Providers in Racine, WI by specialty
• Home Health Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.