Provider Demographics
NPI:1962086447
Name:ZIELINSKI, SANDRA JEAN (NBC-WHC, FMCHC)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:JEAN
Last Name:ZIELINSKI
Suffix:
Gender:F
Credentials:NBC-WHC, FMCHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56720 WINDSOR AVE APT SUITE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46619-4728
Mailing Address - Country:US
Mailing Address - Phone:574-276-2629
Mailing Address - Fax:
Practice Address - Street 1:56720 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46619-4728
Practice Address - Country:US
Practice Address - Phone:574-276-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INA-3274173