Individual
SUSAN KEES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
251 E COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9619
(608) 839-3515
Mailing address
251 E COTTAGE GROVE RD, COTTAGE GROVE, WI 53527-9619
(608) 839-3515
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
707-023
WI
363AM0700X
Medical Physician Assistant
Primary
707-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7217
DEAN HEALTH INSURANCE
WI
Enumeration date
05/03/2006
Last updated
11/02/2020
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