Individual
MARLENE J. KLUCZINSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
215 WASHINGTON ST, GRAFTON, WI 53024-1700
(262) 268-6635
(262) 268-5118
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43837700
—
WI
01
—
P00836845
RR MEDICARE
WI
Enumeration date
07/07/2006
Last updated
03/13/2025
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