| Doctor Name: | MRS. NICOLE IVY-KUTZLER |
| NPI Number: | 1164738811 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP |
| License Number: | 759653 |
| Business Practice Address: | 101 Bodin Cir Travis Afb, CA - 945351809 |
| Business Phone Number: | 7078167894 |
| Business Fax Number: | |
| Mailing Address: | 891 Sonnet Dr, VACAVILLE |
| State: | CA |
| Postal Code: | 956877263 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2010 |
| NPI Last Update Date: | 08/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LX0001X |
| License Number: | 759653 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Obstetrics & Gynecology |
| Taxonomy Definition: | |