Provider Demographics
NPI:1174247027
Name:ZBIKOWSKI, CORNELL FAYE (CPM)
Entity type:Individual
Prefix:
First Name:CORNELL
Middle Name:FAYE
Last Name:ZBIKOWSKI
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E JOHNSON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3088
Mailing Address - Country:US
Mailing Address - Phone:608-444-3485
Mailing Address - Fax:
Practice Address - Street 1:3033 EXCELSIOR BLVD STE 585
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-6400
Practice Address - Country:US
Practice Address - Phone:608-444-3485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay