Individual
KELI A IZYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3686 SHORE RD, STURGEON BAY, WI 54235-8242
(920) 743-3956
Mailing address
3686 SHORE RD, STURGEON BAY, WI 54235-8242
(920) 743-3956
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
179456-030
WI
164W00000X
Licensed Practical Nurse
312900-31
WI
Other
Enumeration date
07/15/2010
Last updated
08/17/2011
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