Individual
SUZANNE M. WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
7544 COUNTY ROAD P, PRESQUE ISLE, WI 54557-9369
(715) 686-7281
Mailing address
7544 COUNTY ROAD P, PRESQUE ISLE, WI 54557-9369
(715) 686-7281
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
350 13900
—
WI
Enumeration date
12/02/2006
Last updated
07/09/2007
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