Provider Demographics
NPI:1487833851
Name:KAMZOL-GAZDA, MARZENA (BSN, MSN, CFNP, RNFA)
Entity Type:Individual
Prefix:
First Name:MARZENA
Middle Name:
Last Name:KAMZOL-GAZDA
Suffix:
Gender:F
Credentials:BSN, MSN, CFNP, RNFA
Other - Prefix:
Other - First Name:MARZENA
Other - Middle Name:MONICA
Other - Last Name:KAMZOL-GAZOA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN, MSN, CFNP, RNFA
Mailing Address - Street 1:500 OSBORN BLVD.
Mailing Address - Street 2:
Mailing Address - City:SAULT STE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1822
Mailing Address - Country:US
Mailing Address - Phone:906-635-4460
Mailing Address - Fax:906-635-7872
Practice Address - Street 1:500 OSBORN BLVD
Practice Address - Street 2:
Practice Address - City:SAULT STE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1822
Practice Address - Country:US
Practice Address - Phone:906-635-4460
Practice Address - Fax:906-635-7872
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704193228163WR0006X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant