Provider Demographics
NPI:1205604196
Name:KITOWICZ, ANNA RAE (DNP)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:RAE
Last Name:KITOWICZ
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-2247
Mailing Address - Country:US
Mailing Address - Phone:608-577-9062
Mailing Address - Fax:
Practice Address - Street 1:160 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-2247
Practice Address - Country:US
Practice Address - Phone:608-577-9062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14469363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health