Healthcare Provider Details

I. General information

NPI: 1346156965
Provider Name (Legal Business Name): MONICA JEAN KUZNACIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N PINECREST ST
MILWAUKEE WI
53208-3613
US

IV. Provider business mailing address

245 N PINECREST ST
MILWAUKEE WI
53208-3613
US

V. Phone/Fax

Practice location:
  • Phone: 507-398-8697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1107501-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: