Provider Demographics
NPI:1437473329
Name:UTZIG, KRYSIA ANN (LPN)
Entity Type:Individual
Prefix:
First Name:KRYSIA
Middle Name:ANN
Last Name:UTZIG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2442 CHALET GARDENS CT
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-4433
Mailing Address - Country:US
Mailing Address - Phone:608-772-8287
Mailing Address - Fax:
Practice Address - Street 1:2442 CHALET GARDENS CT
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-4433
Practice Address - Country:US
Practice Address - Phone:608-772-8287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI311706-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse