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SUZANNE M. WALLACE R.N.

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1710055090

Individual Registrant:
 SUZANNE M. WALLACE R.N.
Gender: F
Sole Proprietor

Location and contact information for practice:
7544 COUNTY ROAD P  PRESQUE ISLE, WI 54557-9369 US
Tel: 715-686-7281  Fax: --

Contact information for business:
7544 COUNTY ROAD P  PRESQUE ISLE, WI 54557-9369 US
Tel: 715-686-7281  Fax: --

Registration Information:
NPI: 1710055090
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163W00000XNursing Service Providers
Registered Nurse
WI

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
350 13900WI05




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