Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Jodi L Space, APNP

Individual provider Nurse Practitioner · NPI 1518217280

Mrs. Jodi L Space, APNP is a Nurse Practitioner in Crandon, Wisconsin. Graduated from University of Missouri, Columbia School of Medicine in 2012, 14 years ago. Practices with Forest County Potawatomi Community, a 21-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
14
Trained at
University of Missouri, Columbia School of Medicine
Licensed in
WI
In the registry since
2012
Specialties on file
2

Practice location Address checks out

5416 Everybodys Rd
Crandon, WI 54520-8627
Phone: (715) 478-4890
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 5012-33 (WI)
Nurse Practitioner Taxonomy 363L00000X · Licence 5012 (WI)

Record details

NPI number1518217280
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedSeptember 10, 2012
Last updated in NPPESJanuary 19, 2022
Certification dateJanuary 19, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Forest County Potawatomi Community — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Crandon