Provider Demographics
NPI:1790334373
Name:NOFFKE, JEANINE ANN (FAMILY NURSE PRACTIC)
Entity Type:Individual
Prefix:MISS
First Name:JEANINE
Middle Name:ANN
Last Name:NOFFKE
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIC
Other - Prefix:MRS
Other - First Name:JEANINE
Other - Middle Name:ANN
Other - Last Name:ASHBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2275 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-8360
Mailing Address - Country:US
Mailing Address - Phone:715-361-5482
Mailing Address - Fax:
Practice Address - Street 1:2275 N SHORE DR
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501
Practice Address - Country:US
Practice Address - Phone:715-361-5482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33-9512363LF0000X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily