Basic Information
| Provider Information | |||||||||
| NPI: | 1437208022 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METZ | ||||||||
| FirstName: | KRISTINE | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | MSN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2401 PLOVER RD | ||||||||
| Address2: | |||||||||
| City: | PLOVER | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544673916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152953800 | ||||||||
| FaxNumber: | 7152953833 | ||||||||
| Practice Location | |||||||||
| Address1: | 2401 PLOVER RD | ||||||||
| Address2: | |||||||||
| City: | PLOVER | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544673916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7152953800 | ||||||||
| FaxNumber: | 7152953833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 04/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1576-33 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 1576-33 | 01 | WI | APNP | OTHER |