Provider Demographics
NPI:1164706099
Name:WROBLEWSKI, JESSICA ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELIZABETH
Last Name:WROBLEWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 590
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53008-0590
Mailing Address - Country:US
Mailing Address - Phone:855-855-2710
Mailing Address - Fax:855-855-2710
Practice Address - Street 1:N52W17284 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-7847
Practice Address - Country:US
Practice Address - Phone:855-855-2710
Practice Address - Fax:855-855-2710
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI162900-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse