Provider Demographics
NPI:1255864633
Name:PRONSCHINSKE, JAMIE LEE (RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:PRONSCHINSKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:MAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:501 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COCHRANE
Mailing Address - State:WI
Mailing Address - Zip Code:54622-9501
Mailing Address - Country:US
Mailing Address - Phone:507-990-0960
Mailing Address - Fax:
Practice Address - Street 1:501 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COCHRANE
Practice Address - State:WI
Practice Address - Zip Code:54622-9501
Practice Address - Country:US
Practice Address - Phone:507-990-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI178511-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse