Provider Demographics
NPI:1124364641
Name:KUCZYNSKI, MARGARET ELIZABETH (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:KUCZYNSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ELIZABETH
Other - Last Name:BUTZU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1522 PINE GROVE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3382
Mailing Address - Country:US
Mailing Address - Phone:810-982-3277
Mailing Address - Fax:810-982-0716
Practice Address - Street 1:1522 PINE GROVE AVE STE A
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3382
Practice Address - Country:US
Practice Address - Phone:810-982-3277
Practice Address - Fax:810-982-0716
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704267227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily