Provider Demographics
NPI:1881869220
Name:ZELINGER, JODI A (RN)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:A
Last Name:ZELINGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 KOPMEIER DR
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-2334
Mailing Address - Country:US
Mailing Address - Phone:262-691-4684
Mailing Address - Fax:
Practice Address - Street 1:538 KOPMEIER DR
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-2334
Practice Address - Country:US
Practice Address - Phone:262-691-4684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11436-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38236800Medicaid