Provider Demographics
NPI:1225407661
Name:FLAESCHEL, JESSICA MARIE (APNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:FLAESCHEL
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7226
Mailing Address - Fax:920-445-7229
Practice Address - Street 1:1106 UNIVERSITY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-5109
Practice Address - Country:US
Practice Address - Phone:715-732-2176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164157-30163W00000X
WI6714-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
201501940OtherAMERICAN NURSES CREDENTIALING CENTER