Provider Demographics
NPI:1619289329
Name:POLZIN, DEBORAH KRISTIE (RN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:KRISTIE
Last Name:POLZIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:KRISTIE
Other - Last Name:MEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:546 NORTH OAKHILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2777
Mailing Address - Country:US
Mailing Address - Phone:608-352-7177
Mailing Address - Fax:
Practice Address - Street 1:546 NORTH OAKHILL AVENUE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2777
Practice Address - Country:US
Practice Address - Phone:608-352-7177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI95065-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse