Individual
SUSAN R KUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 398-9491
Mailing address
BOX 78534, MILWAUKEE, WI 53278
(815) 381-7431
(815) 381-7498
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
041277987
IL
363L00000X
Nurse Practitioner
Primary
209-010941
IL
Other
Enumeration date
08/08/2006
Last updated
02/05/2020
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