SUSAN SAMPLE

OSHKOSH, WI
NPI1316496565
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WI  7300-33)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: WI  7300)
Enumeration Date2016-09-29
Last Update Date2021-11-18
Business Address
SUSAN SAMPLE NP
700 N WESTHAVEN DR
OSHKOSH, WI 54904
Phone number: 920-456-2030
Mailing Address
SUSAN SAMPLE NP
700 N WESTHAVEN DR
OSHKOSH, WI 54904-6947
Phone number: 920-456-2030