Active NPI
Jaclyn Joy Webster, R.N., BSN
- Registered Nurse
- Genoa City, WI
National Provider Identifier
1699066118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 177049030
- Practice address
- 1007 Mallard LN
Genoa City, WI 53128-1995 - Phone
- (262) 227-3191
- NPI assigned
- May 2, 2011
- Last updated
- Feb 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 177049030 | WI | Primary |
Addresses
Primary practice location
1007 Mallard LN
Genoa City, WI 53128-1995
Mailing address
1007 Mallard LN
Genoa City, WI 53128-1995
Phone (262) 227-3191
Other names 1
- Miss Jaclyn Joy Gonsiorek
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 177049030 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423699200000",
"number": "1699066118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 MALLARD LN",
"city": "GENOA CITY",
"state": "WI",
"postal_code": "531281995",
"telephone_number": "262-227-3191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 MALLARD LN",
"city": "GENOA CITY",
"state": "WI",
"postal_code": "531281995",
"telephone_number": "262-227-3191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBSTER",
"first_name": "JACLYN",
"middle_name": "JOY",
"name_prefix": "Miss",
"credential": "R.N., BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-02",
"last_updated": "2015-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "177049030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JACLYN",
"last_name": "GONSIOREK",
"middle_name": "JOY",
"prefix": "MISS",
"credential": "RN, BSN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Genoa City, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.