Provider Demographics
NPI:1770751331
Name:STENCEL, JACQUELINE ANN (DC)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:ANN
Last Name:STENCEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JACQELINE
Other - Middle Name:ANN
Other - Last Name:PULS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:5050 W RAWSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9448
Mailing Address - Country:US
Mailing Address - Phone:414-377-8584
Mailing Address - Fax:414-377-8588
Practice Address - Street 1:5050 W RAWSON AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9448
Practice Address - Country:US
Practice Address - Phone:414-377-8584
Practice Address - Fax:414-377-8588
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4396-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1770751331Medicaid
WIWI3200001Medicare PIN