Individual provider · Type 1 NPI
Kimberly Kate Mizelle, APNP
Family Nurse Practitioner · Lake Geneva, WI
NPI number
1497632103
Active
Practice location
N2950 State Road 67
Lake Geneva, WI 53147-2655
Fax (262) 245-4627
Mailing address
225 Grace St
Walworth, WI 53184-9636
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 179925-30 (WI) |
Family Nurse Practitioner: Definition to come...
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About NPI 1497632103
Kimberly Kate Mizelle, APNP's National Provider Identifier is 1497632103, issued on Aug 18, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Lake Geneva, WI. The record was last updated on Oct 15, 2025.