Provider Demographics
NPI:1497028260
Name:KUZ, TERESSA CAROL (NP)
Entity Type:Individual
Prefix:MRS
First Name:TERESSA
Middle Name:CAROL
Last Name:KUZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15959 HALL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-5363
Practice Address - Country:US
Practice Address - Phone:586-247-8609
Practice Address - Fax:586-247-8615
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704245264363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health