Provider Demographics
NPI:1740804913
Name:WARZALA, ANNA E (LPN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:E
Last Name:WARZALA
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:SUNSET RIDGE JEFFERSON
Mailing Address - Street 2:826 E. REINEL STREET, JEFFERSON, WI 53549
Mailing Address - City:JEFFERSON
Mailing Address - State:WI
Mailing Address - Zip Code:53549
Mailing Address - Country:US
Mailing Address - Phone:262-325-7516
Mailing Address - Fax:920-541-3662
Practice Address - Street 1:SUNSET RIDGE JEFFERSON
Practice Address - Street 2:826 E. REINEL STREET, JEFFERSON, WI 53549
Practice Address - City:JEFFERSON
Practice Address - State:WI
Practice Address - Zip Code:53549
Practice Address - Country:US
Practice Address - Phone:262-325-7516
Practice Address - Fax:920-541-3662
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI325109164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse