Individual
LUCILLE MAZZETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3400 E RACINE ST, JANESVILLE, WI 53546-2344
(608) 373-8000
(608) 373-8795
Mailing address
3400 E RACINE ST, JANESVILLE, WI 53546-2344
(608) 373-8000
(608) 373-8795
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
12065-33
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891314050
—
WI
Enumeration date
04/08/2020
Last updated
08/22/2022
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