Individual
SUSAN LIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-7199
(414) 955-0110
Mailing address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-7199
(414) 955-0110
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285234526
—
WI
Enumeration date
10/27/2020
Last updated
01/29/2025
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