MEDICARE: JANE E ZWOLSKI RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	102453	OH

General Provider Information

NPI Number	:	1023258829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE E ZWOLSKI RN

Provider Business Mailing Address
First Line	:	1487 W MAIN ST
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-2803
Country	:	US
Telephone Number	:	937-667-0776
Fax Number	:

Provider Business Practice Location Address
First Line	:	1487 W MAIN ST
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-2803
Country	:	US
Telephone Number	:	937-667-0776
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	03/06/2009

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