Provider Demographics
NPI:1447843537
Name:WETZEL, JODI-LYNN ANN (BSN, RN,)
Entity type:Individual
Prefix:MRS
First Name:JODI-LYNN
Middle Name:ANN
Last Name:WETZEL
Suffix:
Gender:F
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 1:65W JIMMIE LEEDS RD
Mailing Address - Street 2:ATLANTICARE REGIONAL MEDICAL CENTER
Mailing Address - City:POMONA
Mailing Address - State:NJ
Mailing Address - Zip Code:08240
Mailing Address - Country:US
Mailing Address - Phone:609-404-3837
Mailing Address - Fax:609-404-3841
Practice Address - Street 1:65W JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240
Practice Address - Country:US
Practice Address - Phone:609-404-3837
Practice Address - Fax:609-404-3841
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07467900163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant