Keli A Izyk, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

179456-030 Issued in WI

Practice address

3686 Shore Rd
Sturgeon Bay, WI 54235-8242

Phone

(920) 743-3956

NPI assigned

Jul 15, 2010

Last updated

Aug 17, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1649583980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3686 SHORE RD",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542358242",
            "telephone_number": "920-743-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3686 SHORE RD",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542358242",
            "telephone_number": "920-743-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZYK",
        "first_name": "KELI",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "179456-030",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "312900-31",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda J Hollrith Mirkes, M.S., CCC-SLP
• Robert Hobson Hoover, D.D.S.
• Tyler Hubbard, DDS
• Tabitha Huempfner
• Kelley O'Brien Hutchison-Maravilla, OTR/L
• Tia Jackson, MS, LAT, ATC
• Amy L Jahnke, MS, LPC
• Taylor Jandrin
• Jody S Jessup, MS, LPC, RD
• Joel a. Eggert D.D.S.,S.C.

• Registered Nurse in Sturgeon Bay, WI
• Providers in Sturgeon Bay, 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 17, 2011; 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.