Provider Demographics
NPI:1669685665
Name:BIZEK, KATHRYN S (MSN, ACNS-BC,CCRN)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:S
Last Name:BIZEK
Suffix:
Gender:F
Credentials:MSN, ACNS-BC,CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 FULLER RD # 111A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2303
Mailing Address - Country:US
Mailing Address - Phone:734-222-7828
Mailing Address - Fax:313-916-8416
Practice Address - Street 1:2215 FULLER RD # 111A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2303
Practice Address - Country:US
Practice Address - Phone:734-222-7828
Practice Address - Fax:734-845-3296
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704136254364SA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health