Provider Demographics
NPI:1053733642
Name:SIGAFUS, JAMIE (LPN)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:SIGAFUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10195 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:GRATIOT
Mailing Address - State:WI
Mailing Address - Zip Code:53541-9631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10195 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GRATIOT
Practice Address - State:WI
Practice Address - Zip Code:53541-9631
Practice Address - Country:US
Practice Address - Phone:608-482-1817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI317279-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse