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Individual

SUSAN D. BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3113 E WASHINGTON AVE, MADISON, WI 53704-4330
(608) 242-0220
Mailing address
508 PROSPECT AVE, PORTAGE, WI 53901-2017
(608) 742-1883

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
14260031
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14260031
LPN LICENSE NUMBER
WV
05
42016400
WI
Enumeration date
02/07/2007
Last updated
07/09/2007
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