Individual
MS. KELLY LAUREN PITZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1902 MEAD AVE, SHEBOYGAN, WI 53081-6140
(414) 329-4979
Mailing address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 449-7665
(920) 449-7659
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
178183
WI
363L00000X
Nurse Practitioner
Primary
9892
WI
363LF0000X
Family Nurse Practitioner
F12190231
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099262
—
WI
Enumeration date
03/27/2020
Last updated
12/01/2021
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