Provider Demographics
NPI:1316907231
Name:POESCHEL, JANE M (NP)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:POESCHEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 3RD AVE W
Mailing Address - Street 2:
Mailing Address - City:DURAND
Mailing Address - State:WI
Mailing Address - Zip Code:54736-1600
Mailing Address - Country:US
Mailing Address - Phone:715-672-5233
Mailing Address - Fax:715-672-3047
Practice Address - Street 1:1250 3RD AVE W
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:WI
Practice Address - Zip Code:54736-1600
Practice Address - Country:US
Practice Address - Phone:715-672-5233
Practice Address - Fax:715-672-3047
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1489363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43897900Medicaid
WI43897900Medicaid
S86024Medicare UPIN