Jamae Sandra Wierzba, LPN
Individual provider Active NPI Licensed Practical Nurse · Marshall, WI
NPI 1649580416 · NPPES record last updated Oct 14, 2010
Key facts
- NPI
- 1649580416
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 312346-031 (WI)
- Practice address
- 279 County Road BB
Marshall, WI 53559-9685 - Phone
- (608) 333-1363
- NPI assigned
- Oct 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 312346-031 | WI | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 312346-031 | WI | Yes |
Addresses
Primary practice location
279 County Road BB
Marshall, WI 53559-9685
Mailing address
279 County Road BB
Marshall, WI 53559-9685
Phone (608) 333-1363
Other names
- Jamae Sandra Gjermo
Other providers in Marshall, WI
All providers in Marshall, WI · Licensed Practical Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.