Provider Demographics
NPI:1821495649
Name:MAREK, KAYA DENICE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAYA
Middle Name:DENICE
Last Name:MAREK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54829-9024
Mailing Address - Country:US
Mailing Address - Phone:715-416-3378
Mailing Address - Fax:
Practice Address - Street 1:892 27TH AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:WI
Practice Address - Zip Code:54829-9024
Practice Address - Country:US
Practice Address - Phone:715-416-3378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI140724-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse