Basic Information
| Provider Information | |||||||||
| NPI: | 1962592568 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CZERWINSKI | ||||||||
| FirstName: | KAY | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | APNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 824 ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544813112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153427500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 824 ILLINOIS AVE | ||||||||
| Address2: | |||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544813112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153427500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 08/10/2012 | ||||||||
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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 | 363L00000X | 2936 | WI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 124311-30 | 01 | WI | RN LICENSE | OTHER | 2936-33 | 01 | WI | APNP LIC | OTHER |