Provider Demographics
NPI:1255482584
Name:KUZEL, LYNETTE RAE
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:RAE
Last Name:KUZEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 3RD AVE SW
Mailing Address - Street 2:PO BOX 137
Mailing Address - City:PINE CITY
Mailing Address - State:MN
Mailing Address - Zip Code:55063-1443
Mailing Address - Country:US
Mailing Address - Phone:320-629-8055
Mailing Address - Fax:
Practice Address - Street 1:655 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:PINE CITY
Practice Address - State:MN
Practice Address - Zip Code:55063-1443
Practice Address - Country:US
Practice Address - Phone:320-629-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist