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General NPI Number Information
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NPI Number | 1790334373
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Entity Type | Individual
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Provider Name | JEANINE ANN NOFFKE FAMILY NURSE PRACTIC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 5741 STATE HIGHWAY 52
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City | WABENO
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State | WI
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Zip | 54566-9055
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Country | US
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Telephone | 920-883-8782
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Fax |
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Provider Business Mailing Address
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Address Line | 5741 STATE HIGHWAY 52
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City | WABENO
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State | WI
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Zip | 54566-9055
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 33-9512
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 33-9512
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License Number State | WI
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