NPI 1104512052

Gina Louise Jetzer, LPN

Practitioner Licensed Practical Nurse Sheboygan, WI

Practice location

Address: 2405 Cooper Ave, Sheboygan, WI 53083-4202
Phone: (920) 946-2607
Mailing address: 2405 Cooper Ave, Sheboygan, WI 53083-4470

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence 310358-031 (WI)

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Registry record

NPI: 1104512052
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Apr 2023
Record last updated: 13 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.