Provider Demographics
NPI:1548624968
Name:ZAFFRANN, JENNA (MOTR/L)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:ZAFFRANN
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:PETERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:6043 W PLAINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3093
Mailing Address - Country:US
Mailing Address - Phone:414-737-5295
Mailing Address - Fax:
Practice Address - Street 1:9651 PRAIRIE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:PLEASANT PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53158-1948
Practice Address - Country:US
Practice Address - Phone:262-455-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5876-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist