Provider Demographics
NPI:1477282945
Name:ZENKER, MARY ALICE (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ALICE
Last Name:ZENKER
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 1:814 17TH ST NE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-2737
Mailing Address - Country:US
Mailing Address - Phone:701-320-3236
Mailing Address - Fax:
Practice Address - Street 1:814 17TH ST NE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-2737
Practice Address - Country:US
Practice Address - Phone:701-320-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator