Provider Demographics
NPI:1063484343
Name:KUCZENSKI, JUDITH A (FNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:KUCZENSKI
Suffix:
Gender:F
Credentials:FNP
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:651-523-8584
Practice Address - Street 1:3930 NORTHWOODS DR - MAIL STOP 32800A
Practice Address - Street 2:HEALTH PARTNERS ARDEN HILLS CLINIC
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55112-6974
Practice Address - Country:US
Practice Address - Phone:651-523-8500
Practice Address - Fax:651-523-8584
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2011-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR1122275363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN284027800Medicaid
500000437Medicare ID - Type Unspecified
S33620Medicare UPIN