Provider Demographics
NPI:1437208022
Name:METZ, KRISTINE M (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:M
Last Name:METZ
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 PLOVER RD
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-3916
Mailing Address - Country:US
Mailing Address - Phone:715-295-3800
Mailing Address - Fax:715-295-3833
Practice Address - Street 1:2401 PLOVER RD
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-3916
Practice Address - Country:US
Practice Address - Phone:715-295-3800
Practice Address - Fax:715-295-3833
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1576-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1576-33OtherAPNP