IndividualActive
Kizzie Durgom, RN
NPI 1104175694 · Registered Nurse · Racine, WI
Provider details
- NPI number
- 1104175694
- Entity type
- Individual
- Primary specialty
- Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- License
- 16629730 (WI)
Specialties & taxonomies
Nursing Service Providers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2000 Domanik Dr
Racine, WI 53404-2910
Phone: (262) 633-4800
Street-level locationGet directions
Mailing address
2000 Domanik Dr
Racine, WI 53404-2910
Registry dates
- Enumerated
- 2012-08-30
- Last updated
- 2012-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.