Duczak, Kim T

Duczak, Kim T is an individual health care provider with primary practice located at 818 Forrest Ln , Waterford WI 53185. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Duczak, Kim T can be contacted via phone (262) 514-3700.

Contact Information

Primary practice address
818 Forrest Ln Waterford WI 53185
Phone: (262) 514-3700
Fax: (262) 514-3865
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1544-033 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 80028-030 Wisconsin

Profile Details

NPI number 1346355542
LBN Legal business name Duczak, Kim T
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2006
Last updated Dec 1st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346355542 NPPES
Wisconsin MEDICAID 4393500

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