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Contact Information

JILL K KIETZKE, MSN, BC-ADM
640 S 1ST ST
MOUNT HOREB, WI53572-3311
 Phone: 608-512-8115
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Educator

174H00000X
 

Diabetes Educator

163WD0400X
Indicates primary specialty

NPI Profile & details for JILL K KIETZKE · (Female)

NPI # 1730829508
Status Active
Credentials MSN, BC-ADM
Entity Individual
Enumeration date 03/30/2022
Last updated 03/30/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 119707-30
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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