| Doctor Name: | MRS. JUDITH ANN KASZYCA |
| NPI Number: | 1619995503 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NURSE PRACTITONER |
| License Number: | 4704103116 |
| Business Practice Address: | 3532 Main St Deckerville, MI - 484279615 |
| Business Phone Number: | 8103763100 |
| Business Fax Number: | 8103768311 |
| Mailing Address: | 3532 Main St, DECKERVILLE |
| State: | MI |
| Postal Code: | 484279615 |
| Phone Number: | 8103763100 |
| Fax Number: | 8103768311 |
| NPI Enumeration Date: | 07/18/2006 |
| NPI Last Update Date: | 07/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 4704103116 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |