Individual
SUSAN WRONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
14 COTTAGE ST, MEDFORD, OR 97504-7332
(541) 292-6722
(541) 326-0028
Mailing address
14 COTTAGE ST, MEDFORD, OR 97504-7332
(541) 292-6722
(541) 326-0028
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
000033109N6 PMHNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060011000
BLUE CROSS NUMBER
OR
Enumeration date
01/28/2007
Last updated
01/09/2020
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