Provider Demographics
NPI:1003151655
Name:ZAWODNY, DESDY MARIE
Entity type:Individual
Prefix:MRS
First Name:DESDY
Middle Name:MARIE
Last Name:ZAWODNY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DESDY
Other - Middle Name:MARIE
Other - Last Name:ZAWODNY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5153 FERN DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-2429
Mailing Address - Country:US
Mailing Address - Phone:419-475-5173
Mailing Address - Fax:
Practice Address - Street 1:5153 FERN DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-2429
Practice Address - Country:US
Practice Address - Phone:419-475-5173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-09
Last Update Date:2012-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4000-9335-0302376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide