Provider Demographics
NPI:1992422877
Name:GUETZKOW, KAREN J
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:GUETZKOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E ROCKDALE RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:WI
Mailing Address - Zip Code:53523-9424
Mailing Address - Country:US
Mailing Address - Phone:608-445-2389
Mailing Address - Fax:
Practice Address - Street 1:101 E ROCKDALE RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:WI
Practice Address - Zip Code:53523-9424
Practice Address - Country:US
Practice Address - Phone:608-445-2389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI302115164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse