DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MRS. JENELL DIANE JACKLEY CPNP

MEDICARE: MRS. JENELL DIANE JACKLEY CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse041.389592IL
2163W00000XRegistered Nurse163094-030WI
3363LP0200XPediatric Nurse Practitioner209.010138IL
4363LP0200XPediatric Nurse Practitioner12260-33WI

General Provider Information

NPI Number : 1942502612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENELL DIANE JACKLEY CPNP
Provider Business Mailing Address
First Line : 316 BUCK TRL
Second Line :
City : TWIN LAKES
State : WI
Zip : 53181-9637
Country : US
Telephone Number : 262-914-1433
Fax Number :
Provider Business Practice Location Address
First Line : 4006 WASHINGTON RD
Second Line :
City : KENOSHA
State : WI
Zip : 53144-4819
Country : US
Telephone Number : 262-656-0044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2010
Last Update Date : 09/07/2023

Similar Medicare Providers

1740840420 — TYLER W SECOR LPC
Practice Location Address:
4006 WASHINGTON RD
KENOSHA, WI
53144-4819
Practice Phone: 262-656-0044
Practice Fax: 262-649-1977
1811245475 — REBECCA J RODRIGUEZ
Practice Location Address:
4006 WASHINGTON RD
KENOSHA, WI
53144-4819
Practice Phone: 262-656-0044
Practice Fax: 262-925-3255
1841773793 — DONNA M ZAGAME RDH
Practice Location Address:
4006 WASHINGTON RD
KENOSHA, WI
53144-4819
Practice Phone: 262-656-0044
Practice Fax:
1629733886 — COURTNEY CHAPLIN RYAN
Practice Location Address:
4006 WASHINGTON RD
KENOSHA, WI
53144-4819
Practice Phone: 262-204-5697
Practice Fax:
1124773627 — HANNAH DAVIDSON APSW
Practice Location Address:
4006 WASHINGTON RD
KENOSHA, WI
53144-4819
Practice Phone: 262-656-0044
Practice Fax: 262-649-1977
1407503279 — LUIS DANIEL RUIZ GONZALEZ RDH
Practice Location Address:
4006 WASHINGTON RD
KENOSHA, WI
53144-4819
Practice Phone: 262-771-3553
Practice Fax:

Directions to “ MRS. JENELL DIANE JACKLEY CPNP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.