Kluczinske, Marlene J.

Kluczinske, Marlene J. is an individual health care provider with primary practice located at 1777 W Grand Ave , Port Washington WI 53074-2077. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Kluczinske, Marlene J. can be contacted via phone (262) 284-3456.

Contact Information

Primary practice address
1777 W Grand Ave Port Washington WI 53074-2077
Phone: (262) 284-3456
Fax: (262) 284-4543
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 53 Wisconsin

Profile Details

NPI number 1891727715
LBN Legal business name Kluczinske, Marlene J.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Dec 1st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891727715 NPPES
Wisconsin Other P00836845 RR MEDICARE
Wisconsin MEDICAID 43837700 RR MEDICARE

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