Provider Demographics
NPI:1306513924
Name:JAZDZEWSKI, LYNDSEY (RN)
Entity type:Individual
Prefix:MRS
First Name:LYNDSEY
Middle Name:
Last Name:JAZDZEWSKI
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 1:27 N KAYSER ST
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-3705
Mailing Address - Country:US
Mailing Address - Phone:920-615-1994
Mailing Address - Fax:
Practice Address - Street 1:W4108 JENNIE LEE CT
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:WI
Practice Address - Zip Code:53049-1708
Practice Address - Country:US
Practice Address - Phone:920-522-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI235381163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical