Provider Demographics
NPI:1750175774
Name:JELINEK, LISA ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:JELINEK
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 PRAIRIE STONE CT SE
Mailing Address - Street 2:
Mailing Address - City:STEWARTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55976-1657
Mailing Address - Country:US
Mailing Address - Phone:507-358-6754
Mailing Address - Fax:
Practice Address - Street 1:113 PRAIRIE STONE CT SE
Practice Address - Street 2:
Practice Address - City:STEWARTVILLE
Practice Address - State:MN
Practice Address - Zip Code:55976-1657
Practice Address - Country:US
Practice Address - Phone:507-358-6754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1574506163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency