Individual
ELLEN KUCZYNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
6644 CHECKERBERRY LN NE, ROCKFORD, MI 49341-8918
(616) 450-2643
Mailing address
6644 CHECKERBERRY LN NE, ROCKFORD, MI 49341-8918
(616) 450-2643
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
63331
MI
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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