Provider Demographics
NPI:1629378187
Name:KRZYKOWSKI, HEATHER (RN)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:KRZYKOWSKI
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 1:4021 MAPLEDALE CT
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-2708
Mailing Address - Country:US
Mailing Address - Phone:715-424-3883
Mailing Address - Fax:
Practice Address - Street 1:4021 MAPLEDALE CT
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-2708
Practice Address - Country:US
Practice Address - Phone:715-424-3883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI138798163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse