Individual provider Active NPI

Alyssa Nichole Kitzman I, L.P.N.

  • Licensed Practical Nurse
  • Hurley, WI
National Provider Identifier
1639428170
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
316225-031 Issued in WI
Practice address
4788 W. Center Dr.
Hurley, WI 54534-9319
Phone
(715) 862-2954
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 316225-031 WI Primary

Addresses

Primary practice location

4788 W. Center Dr.
Hurley, WI 54534-9319

Mailing address

4788 W. Center Dr.
Hurley, WI 54534-9319
Phone (715) 862-2954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
316225-031WIMDLicensed Practical Nurse

NPI Registry JSON

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": "1639428170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4788 W. CENTER DR.",
            "city": "HURLEY",
            "state": "WI",
            "postal_code": "545349319",
            "telephone_number": "715-862-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4788 W. CENTER DR.",
            "city": "HURLEY",
            "state": "WI",
            "postal_code": "545349319",
            "telephone_number": "715-862-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITZMAN",
        "first_name": "ALYSSA",
        "middle_name": "NICHOLE",
        "name_prefix": "Miss",
        "name_suffix": "I",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "316225-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurley, WI

Sources for this page

  • 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.