Individual
MS. MARY JO KAUTZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
112 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2331
Mailing address
112 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2331
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6934-33
WI
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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