Individual
JILL KRISTEN KIETZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, BC-ADM
Contact information
Practice address
640 S 1ST ST, MOUNT HOREB, WI 53572-3311
(608) 512-8115
Mailing address
640 S 1ST ST, MOUNT HOREB, WI 53572-3311
(608) 512-8115
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
119707-30
WI
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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