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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. JENELL DIANE JACKLEY, CPNP

Active Sole Proprietor

MRS. JENELL DIANE JACKLEY, CPNP is a Pediatric Nurse Practitioner healthcare provider located in KENOSHA, Wisconsin. NPI 1942502612 is currently active in the NPPES registry. Verify at CMS.

Pediatric Nurse Practitioner · KENOSHA, WI

Registration Details

NPI Number
1942502612
Provider Type
Individual
Gender
Female
NPI Issued
Nov 30, 2010 (15.671887536005 yrs)
Last Updated
Sep 7, 2023
Licenses
041.389592 (IL)
163094-030 (WI)
209.010138 (IL)
12260-33 (WI)
Sole Proprietor
Yes

Practice Information

Address
4006 WASHINGTON RD
KENOSHA, WI, 531444819
Browse WI providers · Browse ZIP 53144
Phone
2626560044
Primary Specialty
Pediatric Nurse Practitioner
363LP0200X
Additional Specialty
Registered Nurse
Additional Specialty
Pediatric Nurse Practitioner
Additional Specialty
Pediatric Nurse Practitioner

Other Pediatric Nurse Practitioner Providers in KENOSHA, WI

Name Credential NPI
MRS. TANYA M. HOAR NP 1891933552
AEMELIA ANNE TALLEN-WHITED CPNP 1831402734
LORI ELLA WYSONG CPNP-PC 1881046324
ALISON D FRITSCHLER APNP 1912496290
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.