Individual
MRS. MELANIE AGNES KUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
606 E THEODORE ST, JEFFERSON, WI 53549-2186
(920) 723-4571
Mailing address
606 E THEODORE ST, JEFFERSON, WI 53549-2186
(920) 723-4571
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
35042800
WI
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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