Individual
SUSAN JANICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 STATE RD # 33, LA CROSSE, WI 54601-5098
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3063-033
WI
363LF0000X
Family Nurse Practitioner
R142404-1
MN
Other
Enumeration date
12/18/2006
Last updated
02/26/2018
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