Healthcare Provider Details

I. General information

NPI: 1134035942
Provider Name (Legal Business Name): JAYDA R ZEMLICKA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 14TH AVE NE
WATERTOWN SD
57201-6811
US

IV. Provider business mailing address

511 14TH AVE NE
WATERTOWN SD
57201-6811
US

V. Phone/Fax

Practice location:
  • Phone: 605-886-8482
  • Fax: 605-884-4332
Mailing address:
  • Phone: 605-886-8482
  • Fax: 605-884-4332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1745
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: