Individual
MRS. SUSAN MARIE STANASZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., B.S.N., R.C.S.
Contact information
Practice address
3541 EVERGREEN AVE, GREEN BAY, WI 54313-7415
(920) 434-9450
Mailing address
3541 EVERGREEN AVE, GREEN BAY, WI 54313-7415
(920) 434-9450
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
163WC0400X
Case Management Registered Nurse
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38217400
—
WI
Enumeration date
05/03/2007
Last updated
10/18/2007
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