Provider Demographics
NPI:1619766763
Name:LUTZ, LEANNE LYNNE (MSN RN)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:LYNNE
Last Name:LUTZ
Suffix:
Gender:F
Credentials:MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HIGHLAND AVE RM 4159
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2202
Mailing Address - Country:US
Mailing Address - Phone:608-263-5200
Mailing Address - Fax:
Practice Address - Street 1:701 HIGHLAND AVE RM 4159
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2202
Practice Address - Country:US
Practice Address - Phone:608-263-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI226425-30163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency