Provider Demographics
NPI:1134551997
Name:KIZEWSKI, ADAM (RN)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:KIZEWSKI
Suffix:
Gender:M
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:UNIT 25850 BOX 7
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09033-5850
Mailing Address - Country:US
Mailing Address - Phone:314-354-6773
Mailing Address - Fax:
Practice Address - Street 1:UNIT 25850 BOX 7
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09033-5850
Practice Address - Country:US
Practice Address - Phone:314-354-6773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX779808163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse