Provider Demographics
NPI:1619340403
Name:ZWOLINSKI, JESSICA LYNN (NP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:ZWOLINSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1661 CRYSTAL SPRINGS BLVD SE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-4461
Mailing Address - Country:US
Mailing Address - Phone:616-326-0114
Mailing Address - Fax:616-369-3790
Practice Address - Street 1:1661 CRYSTAL SPRINGS BLVD SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-7478
Practice Address - Country:US
Practice Address - Phone:616-326-0114
Practice Address - Fax:616-369-3790
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17640-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0158596Medicaid
OHP01787311Medicare PIN
OHH393410Medicare PIN