Provider Demographics
NPI:1487015996
Name:VANZANDT, JULE
Entity Type:Individual
Prefix:
First Name:JULE
Middle Name:
Last Name:VANZANDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:TRIMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56176-9601
Mailing Address - Country:US
Mailing Address - Phone:218-220-8881
Mailing Address - Fax:
Practice Address - Street 1:820 WINNEBAGO AVE
Practice Address - Street 2:#3
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-3645
Practice Address - Country:US
Practice Address - Phone:507-235-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2152260163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health