Mrs Gwen Annette Jellish, LPN is a
Licensed Practical Nurse based in Sherwood, Wisconsin. Mrs Gwen Annette Jellish is licensed to practice in Wisconsin (license number 6880-031) and her current practice location is
N8160 Big Lake Ln, Sherwood, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(920) 475-4489.
NPI number for Mrs Gwen Annette Jellish is 1326194853 and her current mailing address is N8160 Big Lake Ln, Sherwood, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1326194853.
Provider's Profile
Full Name | Mrs Gwen Annette Jellish |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | N8160 Big Lake Ln, Sherwood, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1326194853
- Provider Enumeration Date: 01/26/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Gwen Annette Jellish such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1326194853 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 6880-031 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Gwen Annette Jellish is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Gwen Annette Jellish, LPN N8160 Big Lake Ln, Sherwood, WI 54169-9666 Ph: (920) 475-4489 | Mrs Gwen Annette Jellish, LPN N8160 Big Lake Ln, Sherwood, WI 54169-9666 Ph: (920) 475-4489 |
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