Provider Demographics
NPI:1568879765
Name:KARL, JESSIE ANN (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:JESSIE
Middle Name:ANN
Last Name:KARL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GENERAL DELIVERY
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-9999
Mailing Address - Country:US
Mailing Address - Phone:715-315-1928
Mailing Address - Fax:
Practice Address - Street 1:8123 YELLOWSTONE DR
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-9039
Practice Address - Country:US
Practice Address - Phone:715-615-0821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-20
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152658-30163W00000X
WI152658030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse