| Doctor Name: | JESSICA PHALEN |
| NPI Number: | 1265897649 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 133089-30 |
| Business Practice Address: | 1900 N Dewey Ave Reedsburg, WI - 539592214 |
| Business Phone Number: | 6085246477 |
| Business Fax Number: | 6085248305 |
| Mailing Address: | 1900 N Dewey Ave, REEDSBURG |
| State: | WI |
| Postal Code: | 539592214 |
| Phone Number: | 6085246477 |
| Fax Number: | 6085248305 |
| NPI Enumeration Date: | 12/29/2015 |
| NPI Last Update Date: | 12/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 133089-30 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |