Provider Demographics
NPI:1558754192
Name:ZAVADIL, JEAN LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:LYNN
Last Name:ZAVADIL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:JEANNIE
Other - Middle Name:LYNN
Other - Last Name:ZAVADIL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:222 9TH AVE WEST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308
Mailing Address - Country:US
Mailing Address - Phone:320-763-3912
Mailing Address - Fax:320-763-6629
Practice Address - Street 1:222 9TH AVE WEST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308
Practice Address - Country:US
Practice Address - Phone:320-763-3912
Practice Address - Fax:320-763-6629
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR201606-3163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse