Healthcare Provider Details

I. General information

NPI: 1154821361
Provider Name (Legal Business Name): LINDSEY ZAGRABELNY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 02/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 S 10TH ST
WAUSAU WI
54403-6502
US

IV. Provider business mailing address

1921 FAIRMOUNT ST
WAUSAU WI
54403-6864
US

V. Phone/Fax

Practice location:
  • Phone: 715-570-8912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number235606
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: