Provider Demographics
NPI:1932403292
Name:PRZYBYLSKI, MARY JEAN (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JEAN
Last Name:PRZYBYLSKI
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 1:635 IVY AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-3422
Mailing Address - Country:US
Mailing Address - Phone:651-771-2420
Mailing Address - Fax:651-771-2421
Practice Address - Street 1:635 IVY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-3422
Practice Address - Country:US
Practice Address - Phone:651-771-2420
Practice Address - Fax:651-771-2421
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR857253163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health