Healthcare Provider Details

I. General information

NPI: 1316907231
Provider Name (Legal Business Name): JANE M POESCHEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 03/07/2023
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 3RD AVE W
DURAND WI
54736-1600
US

IV. Provider business mailing address

1250 3RD AVE W
DURAND WI
54736-1600
US

V. Phone/Fax

Practice location:
  • Phone: 715-672-5233
  • Fax: 715-672-3047
Mailing address:
  • Phone: 715-672-5233
  • Fax: 715-672-3047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1489
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: