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Individual

COURTNEY SUMIDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP, AGPCNP-BC, CSFA

Contact information

Practice address
1905 E HUEBBE PKWY, BELOIT, WI 53511-1896
(608) 364-2230
(608) 363-7394
Mailing address
1905 E HUEBBE PKWY, BELOIT, WI 53511-1896
(608) 364-2230
(608) 363-7394

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041442675
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209.026121
IL

Other

Enumeration date
05/17/2022
Last updated
06/25/2024
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