Individual provider Active NPI

Jill Marie Watzka, RN, BSN

  • School Registered Nurse
  • Green Bay, WI
National Provider Identifier
1780511097
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
126989-30 Issued in WI
Practice address
200 S Broadway
Green Bay, WI 54303-1516
Phone
(920) 448-2000
Fax
(920) 272-7662
NPI assigned
May 8, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 126989-30 WI Primary

Addresses

Primary practice location

200 S Broadway
Green Bay, WI 54303-1516

Mailing address

1246 Benjamin CT
Green Bay, WI 54311-5549
Phone (920) 639-8862

Other practice location 1

2765 Sussex Rd
Green Bay, WI 54311-7295
Phone (920) 391-2425

Other practice location 2

539 Laverne Dr
Green Bay, WI 54311-5720
Phone (920) 391-2410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
126989-30WIMDSchool Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1780511097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 BENJAMIN CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115549",
            "telephone_number": "920-639-8862",
            "fax_number": "920-272-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S BROADWAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031516",
            "telephone_number": "920-448-2000",
            "fax_number": "920-272-7662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2765 Sussex Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543117295",
            "country_code": "US",
            "telephone_number": "920-391-2425",
            "fax_number": "920-272-7662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "539 Laverne Dr",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543115720",
            "country_code": "US",
            "telephone_number": "920-391-2410",
            "fax_number": "920-272-7662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATZKA",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-08",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WI",
            "license": "126989-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.