Healthcare Provider Details

I. General information

NPI: 1952845679
Provider Name (Legal Business Name): JENNIFER VOZEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2016
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40036 BLOOMFIELD RD
BURLINGTON WI
53105
US

IV. Provider business mailing address

PO BOX 101
POWERS LAKE WI
53159-0101
US

V. Phone/Fax

Practice location:
  • Phone: 262-206-5478
  • Fax:
Mailing address:
  • Phone: 262-206-5478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number148715
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: