Provider Demographics
NPI:1598498719
Name:KUCZKA, SUSANA
Entity Type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:
Last Name:KUCZKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUSI
Other - Middle Name:
Other - Last Name:KUCZKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4305 NW POINT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63051-4309
Mailing Address - Country:US
Mailing Address - Phone:314-326-3474
Mailing Address - Fax:
Practice Address - Street 1:4305 NW POINT DR
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051-4309
Practice Address - Country:US
Practice Address - Phone:314-326-3474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula