Provider Demographics
NPI:1215812896
Name:ZIWICKI, LANDRIE ALYSE
Entity type:Individual
Prefix:
First Name:LANDRIE
Middle Name:ALYSE
Last Name:ZIWICKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LANDRIE
Other - Middle Name:ALYSE
Other - Last Name:WALZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10550 65TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56329-9552
Mailing Address - Country:US
Mailing Address - Phone:320-828-3720
Mailing Address - Fax:
Practice Address - Street 1:8025 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5360
Practice Address - Country:US
Practice Address - Phone:515-271-1569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program