Individual
MS. SUSAN LISA GRISWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1505 NORTH DR, WINNEBAGO, WI 54985
(920) 426-4310
Mailing address
457 W 11TH AVE, OSHKOSH, WI 54902-6413
(920) 410-6518
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
14310-33
WI
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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