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Individual

MS. KIM T DUCZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
818 FORREST LN, WATERFORD, WI 53185
(262) 514-3700
(262) 514-3865
Mailing address
3301 W FOREST HOME AVE, MILWAUKEE, WI 53215-2843
(262) 514-3700
(262) 514-3865

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1544-033
WI
363L00000X
Nurse Practitioner
80028-030
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4393500
WI
Enumeration date
08/20/2006
Last updated
12/01/2021
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