Individual
MARY B FUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54305-3400
(920) 433-5582
Mailing address
P O BOX 23400, GREEN BAY, WI 54305-3400
(920) 445-7217
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
58343-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43277000
—
WI
Enumeration date
02/28/2007
Last updated
07/08/2007
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