Jazmine Mendez

Individual provider Active NPI Community Health Registered Nurse · Deforest, WI

NPI 1871244558 · NPPES record last updated Jan 13, 2022

Key facts

NPI
1871244558
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
230074 (WI)
Practice address
215 N Lexington Pkwy
Deforest, WI 53532-3004
Phone
(608) 417-0193
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
230074WIMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 230074 WI Yes

Addresses

Primary practice location

215 N Lexington Pkwy
Deforest, WI 53532-3004

Mailing address

215 N Lexington Pkwy
Deforest, WI 53532-3004
Phone (608) 417-0193

Other providers in Deforest, WI

All providers in Deforest, WI · Community Health Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.