Provider Demographics
NPI:1093507733
Name:OELTJEN, JONATHAN DEAN (BSN, RN)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:DEAN
Last Name:OELTJEN
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E KILBOURN AVE APT 903
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3790
Mailing Address - Country:US
Mailing Address - Phone:320-766-8830
Mailing Address - Fax:
Practice Address - Street 1:700 E KILBOURN AVE APT 903
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-3790
Practice Address - Country:US
Practice Address - Phone:320-766-8830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program