Individual
SUSAN K IPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1520 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-5500
(920) 563-4472
Mailing address
1520 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-5500
(920) 563-4472
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1760-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43968400
—
WI
01
—
IPSENSUS
MERCYCARE INSURANCE
WI
01
—
P00963577DB7792
RR MEDICARE
WI
Enumeration date
05/07/2007
Last updated
02/06/2015
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