Provider Demographics
NPI:1891081113
Name:ZENNER, DEBRA JEANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JEANNE
Last Name:ZENNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:JEANNE
Other - Last Name:YARON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:143 SOUTH GIBSON ST.
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451
Mailing Address - Country:US
Mailing Address - Phone:715-748-2121
Mailing Address - Fax:715-748-7590
Practice Address - Street 1:143 SOUTH GIBSON ST.
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451
Practice Address - Country:US
Practice Address - Phone:715-748-2121
Practice Address - Fax:715-748-7590
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4483363LF0000X
WI4483-33363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily