Provider Demographics
NPI:1033684014
Name:WOZNIAK, JESSICA R (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:WOZNIAK
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-473-6633
Mailing Address - Fax:419-539-6306
Practice Address - Street 1:3110 W CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-2956
Practice Address - Country:US
Practice Address - Phone:419-473-6633
Practice Address - Fax:419-539-6306
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704372033163W00000X, 363LA2100X
OHRN.372039163WE0003X
OHAPRN.CNP.023511363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WE0003XNursing Service ProvidersRegistered NurseEmergency