Provider Demographics
NPI:1316999139
Name:KRZYWDA, ELIZABETH A (NP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:A
Last Name:KRZYWDA
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DEPARTMENT OF GENERAL SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-5800
Mailing Address - Fax:414-805-5809
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DEPARTMENT OF GENERAL SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-5800
Practice Address - Fax:414-805-5809
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1292033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
000018515UOtherHUMANA
WI1316999139Medicaid
000018515UOtherHUMANA
S61291Medicare UPIN