Healthcare Provider Details

I. General information

NPI: 1285322024
Provider Name (Legal Business Name): MS. HALEY KUZNACIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11430 N PORT WASHINGTON RD
MEQUON WI
53092-3414
US

IV. Provider business mailing address

1635 N WATER ST APT 418
MILWAUKEE WI
53202-3661
US

V. Phone/Fax

Practice location:
  • Phone: 262-518-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: