Individual
SUSAN KAY BALTHAZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1916 EASTWOOD DR, STOUGHTON, WI 53589-5250
(608) 333-4969
Mailing address
1916 EASTWOOD DR, STOUGHTON, WI 53589-5250
(608) 333-4969
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
16791-030
WI
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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