Healthcare Provider Details

I. General information

NPI: 1144159484
Provider Name (Legal Business Name): KARYN NITZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E 1ST AVE
STANLEY WI
54768-1279
US

IV. Provider business mailing address

507 E 1ST AVE
STANLEY WI
54768-1279
US

V. Phone/Fax

Practice location:
  • Phone: 715-644-5534
  • Fax:
Mailing address:
  • Phone: 715-456-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number156938-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: