Individual
DR. SUZANNE EICKERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APNP, DC
Contact information
Practice address
1500 HERITAGE RD STE A, DE PERE, WI 54115-4017
(920) 347-1990
Mailing address
1500 HERITAGE RD STE A, DE PERE, WI 54115-4017
(920) 347-1990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3298
WI
363L00000X
Nurse Practitioner
Primary
6239-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38990100
—
WI
01
—
K400210431
MEDICARE ID ASSOCIATED WITH REASSIGNMENT OF BENEFITS
WI
Enumeration date
04/21/2006
Last updated
07/14/2015
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