Healthcare Provider Details

I. General information

NPI: 1346187317
Provider Name (Legal Business Name): JENNIFER LEWANDOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S GAMMON RD
MADISON WI
53717-1403
US

IV. Provider business mailing address

2014 ERB RD
VERONA WI
53593-8995
US

V. Phone/Fax

Practice location:
  • Phone: 608-663-6440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number261685
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: