Provider Demographics
NPI:1962177139
Name:ZOLKOWSKI, CHRISTOPHER JOHN (ADN RN)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:ZOLKOWSKI
Suffix:
Gender:M
Credentials:ADN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 MILLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-1641
Mailing Address - Country:US
Mailing Address - Phone:920-284-3982
Mailing Address - Fax:
Practice Address - Street 1:345 MILLINGTON DR
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-1641
Practice Address - Country:US
Practice Address - Phone:920-284-3982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI147719163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse