Individual
AMANDA LEE SUINO-MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
13447 W COUNTY ROAD B, HAYWARD, WI 54843-2259
(715) 558-7883
(715) 558-7348
Mailing address
13447 W COUNTY ROAD B, HAYWARD, WI 54843-2259
(715) 558-7883
(715) 558-7348
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
141483-30
WI
363LF0000X
Family Nurse Practitioner
Primary
5436-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356684880
—
WI
Enumeration date
04/03/2013
Last updated
01/27/2022
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