Provider Demographics
NPI:1871026559
Name:ALOMEPE, JACQUELINE
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:ALOMEPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W124N13585 WASAUKEE RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-1329
Mailing Address - Country:US
Mailing Address - Phone:414-364-3775
Mailing Address - Fax:
Practice Address - Street 1:5000 W NATIONAL AVE
Practice Address - Street 2:CLEMENT ZABLOCKI VETERAN MEDICAL CENTER
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53295
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI147919163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse