MRS. THERESE L. JAECKLE (NPI# 1063696516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063696516 |
| Entity Type | Individual |
| Full Name | MRS. THERESE L. JAECKLE |
| Other Name | MS. THERESE ANN LUPONE |
| Credential | MSN, APNP |
| Practice Address |
W62n248 Washington Ave Cedarburg WI 53012-2768 |
| Mailing Address |
4670 N 143rd St Brookfield WI 53005-1664 |
| Practice Telephone | 2623751116 |
| Mailing Telephone | 2627810297 |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2009-02-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
3319-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
3319-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
W62N248 WASHINGTON AVE |
| City | CEDARBURG |
| State | WI |
| Zip Code | 53012-2768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437124617 | Donald J. Meyer | Family Medicine | W62n248 Washington Ave, Cedarburg, WI 53012-2768 | 2006-02-21 |
| 1235666017 | Myles Tonnacliff Ph.d, LLC | Clinic/Center | W62n248 Washington Ave, Suite 208, Cedarburg, WI 53012-2768 | 2017-05-11 |
| 1215320908 | David Dich | Counselor | W62n248 Washington Ave, Suite#207, Cedarburg, WI 53012-2768 | 2015-03-05 |
| 1508281668 | Sue Jennings | Social Worker | W62n248 Washington Ave, Suite#207, Cedarburg, WI 53012-2768 | 2014-02-26 |
| 1043551039 | Nicole M Scher-hubing | Social Worker | W62n248 Washington Ave, Suite#207, Cedarburg, WI 53012-2768 | 2013-03-15 |
| 1831430776 | Lindsey Marie Baldwin | Social Worker | W62n248 Washington Ave, Suite#207, Cedarburg, WI 53012-2768 | 2013-03-01 |
| 1184899015 | Donald J. Meyer, Dosc | Family Medicine | W62n248 Washington Ave, Cedarburg, WI 53012-2768 | 2008-04-22 |
| 1720201163 | Northshore Clinic & Consultants, Inc. | Community/Behavioral Health | W62n248 Washington Ave, Suite #207, Cedarburg, WI 53012-2768 | 2007-04-11 |
| 1407079866 | Joy A Myers | Counselor | W62n248 Washington Ave, Suite #207, Cedarburg, WI 53012-2768 | 2007-04-11 |
| 1972726370 | Dennis Clark Weeden | Social Worker | W62n248 Washington Ave, Suite#207, Cedarburg, WI 53012-2768 | 2007-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639565351 | Angela Marie Phillips | Counselor | 8750 Western Rd, Cedarburg, WI 53012 | 2015-04-09 |
| 1922403641 | Nickolas Wimble | Hearing Instrument Specialist | W62n244 Washinton St, #104, Cedarburg, WI 53012 | 2014-10-23 |
| 1285902429 | Mary B Pistiner | Pharmacist | W62 N190 Washington Ave, Walgreens, Cedarburg, WI 53012 | 2011-12-02 |
| 1285931360 | Accuquest Hearing Centers | Clinic/Center | N54w65 Mill Street, Ste 800, Cedarburg, WI 53012 | 2011-02-25 |
| 1417283532 | Laura Egan Cutler | Speech-Language Pathologist | N87 W6334 Brookdale Dr, Cedarburg, WI 53012 | 2009-10-23 |
| 1790945053 | Diane M Kerkman | Licensed Practical Nurse | W63 N14264 Washington Ave #13, Cedarburg, WI 53012 | 2008-06-11 |
| 1346416856 | Robert H Schwengel | Dentist | W62n179 Washington Ave, Cedarburg, WI 53012 | 2008-05-05 |
| 1174710479 | Assisted Living Concepts Inc | Assisted Living Facility | W56 N225 Mckinley Blvd, Cedarburg, WI 53012 | 2007-10-01 |
| 1699968016 | Jay Timothy Brogelman | Occupational Therapy Assistant | N27 W5707 Lincoln Blvd., Cedar Springs Health and Rehabilitation Center, Cedarburg, WI 53012 | 2007-08-20 |
| 1053517722 | Bruce J Stevens | Dentist | N52 W6295 Mill Street, Cedarburg, WI 53012 | 2007-06-21 |
| Find all providers in zip 53012 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422726 | Wisconsin Healthcare Family Practices and Behavioral Services LLC | Nurse Practitioner | 10721 W Capitol Dr Ste G103, Wauwatosa, WI 53222-1210 | 2020-09-17 |
| 1689292856 | Julianne Margaret John | Nurse Practitioner | 3237 S 16th St Ste 310, Milwaukee, WI 53215-4526 | 2020-07-13 |
| 1356968002 | Marisa Hiley | Nurse Practitioner | W129 N7055 Northfield Drive, Menomonee Falls, WI 53051 | 2020-06-29 |
| 1932726700 | Lauren Marie Skemp | Nurse Practitioner | 1960 Hyview Rd, Cuba City, WI 53807-9718 | 2020-06-28 |
| 1235779240 | Conscious Practice, LLC | Nurse Practitioner | 119 19th St N, La Crosse, WI 54601-3724 | 2020-01-08 |
| 1073152161 | Stephanie L Ruskell | Nurse Practitioner | 3805 Spring St Ste 240, Mount Pleasant, WI 53405-1667 | 2020-01-06 |
| 1558924811 | Sarah Kathryn Garven | Nurse Practitioner | 5000 West National Ave Rm 3119, Milwaukee, WI 53295-1000 | 2019-04-22 |
| 1104394535 | Therese Ann Alm | Nurse Practitioner | 383 Williamstowne Ste 101, Delafield, WI 53018-2332 | 2018-11-03 |
| 1477079242 | Aeron Rachel Adams | Nurse Practitioner | W10237 Lake Emily Rd, Fox Lake, WI 53933 | 2017-08-14 |
| 1396140398 | Monica Gorski | Nurse Practitioner | 505 King St Ste 218, La Crosse, WI 54601-4289 | 2014-11-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MRS. THERESE L. JAECKLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.