Kizzie Marie Durgom, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

16629730 Issued in WI

Practice address

2000 Domanik Dr
Racine, WI 53404-2910

Phone

(262) 633-4800

NPI assigned

Aug 30, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1104175694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 DOMANIK DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534042910",
            "telephone_number": "262-633-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 DOMANIK DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534042910",
            "telephone_number": "262-633-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURGOM",
        "first_name": "KIZZIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "16629730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DRS Decheck and Mataczynski MD SC
• Olivia Jean Drwiega, OTD, OTR/L
• Walter Matthew Drymalski, SAC-IT
• Nectarios Duchac
• Paul C. Durbin, M.D.
• Mary C. Dutkiewicz, N.P.
• Richard Dvorsky, RPH
• Juliann Kay Dykstra, B.C.-H.I.S.
• Dynamic Potential
• E Bruns Foot and Ankle SC

• Registered Nurse in Racine, WI
• Providers in Racine, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.