Individual
SUSAN ANN THORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, SUITE 777, MILWAUKEE, WI 53215-3669
(414) 649-3370
(414) 649-3278
Mailing address
PO BOX 2040, MILWAUKEE, WI 53201-2040
(414) 649-3370
(414) 649-5769
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
002106787
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36044900
—
WI
Enumeration date
08/05/2007
Last updated
08/31/2009
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