Provider Demographics
NPI:1275667446
Name:ZIELKE, JUDITH ELLEN (RN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ELLEN
Last Name:ZIELKE
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4986 N ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1416
Mailing Address - Country:US
Mailing Address - Phone:248-475-4726
Mailing Address - Fax:248-475-5777
Practice Address - Street 1:4986 N ADAMS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48306-1416
Practice Address - Country:US
Practice Address - Phone:248-475-4726
Practice Address - Fax:248-475-5777
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704114826163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator