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Jesse Jorgensen
NPI 1649687401 · on the registry since 2014
Practice
- Address
- 1700 30th Ave Apt 1
Monroe, WI 53566 - Phone
- (920) 609-8530
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 2255A2300X
- Licence states on file
- IL, WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-07-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin