Provider Demographics
NPI:1780191916
Name:TOCZYL, LUCIE
Entity Type:Individual
Prefix:
First Name:LUCIE
Middle Name:
Last Name:TOCZYL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3742 E WHITTAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-1150
Mailing Address - Country:US
Mailing Address - Phone:912-656-3981
Mailing Address - Fax:
Practice Address - Street 1:3742 E WHITTAKER AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-1150
Practice Address - Country:US
Practice Address - Phone:912-656-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI313268-31164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty