Individual
SUSAN EVANS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1561 HILLINGTON DR, NEENAH, WI 54956-8940
(920) 727-9994
Mailing address
1561 HILLINGTON DR, NEENAH, WI 54956-8940
(920) 727-9994
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
672-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0434340
PROVIDER NUMBER
WI
Enumeration date
03/31/2006
Last updated
07/08/2007
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