Healthcare Provider Details

I. General information

NPI: 1164356903
Provider Name (Legal Business Name): JACQUELINE M MAJERLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6645 SUMMER MEADOWS DR NE
ROCKFORD MI
49341-7557
US

IV. Provider business mailing address

6645 SUMMER MEADOWS DR NE
ROCKFORD MI
49341-7557
US

V. Phone/Fax

Practice location:
  • Phone: 928-607-9014
  • Fax:
Mailing address:
  • Phone: 928-607-9014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704346438
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: