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1265554240
SUZANNE BETH WALLACE
MADISON, WI
NPI
1265554240
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: WI 3054-033)
Enumeration Date
2007-04-03
Last Update Date
2007-07-08
Business Address
Ms. SUZANNE BETH WALLACE APRN,BC
2500 OVERLOOK TER
MADISON, WI 53705-2254
Phone number: 608-256-1901
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Mailing Address
Ms. SUZANNE BETH WALLACE APRN,BC
1826 VAN HISE AVE
MADISON, WI 53726-4053
Phone number: 608-236-9071
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