Provider Demographics
NPI:1043656978
Name:SZULCZEWSKI, JANE A (LPN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:SZULCZEWSKI
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 1:2249 S 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2303
Mailing Address - Country:US
Mailing Address - Phone:414-551-9263
Mailing Address - Fax:
Practice Address - Street 1:2249 S 34TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-2303
Practice Address - Country:US
Practice Address - Phone:414-551-9263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-19
Last Update Date:2013-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21680-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse