Provider Demographics
NPI:1093836058
Name:ZEITLER, PATTI ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:ANN
Last Name:ZEITLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:PATTI
Other - Middle Name:ANN
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N4785 PRAHL RD
Mailing Address - Street 2:
Mailing Address - City:LUXEMBURG
Mailing Address - State:WI
Mailing Address - Zip Code:54217
Mailing Address - Country:US
Mailing Address - Phone:920-845-5482
Mailing Address - Fax:
Practice Address - Street 1:N6185 SCHOOL CREEK TRAIL
Practice Address - Street 2:
Practice Address - City:LUXEMBURG
Practice Address - State:WI
Practice Address - Zip Code:54217
Practice Address - Country:US
Practice Address - Phone:920-845-2128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38278300Medicaid