Individual
SUSAN J WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
205 E CHESTNUT ST, PARDEEVILLE, WI 53954-9125
(920) 627-3040
Mailing address
205 E CHESTNUT ST, PARDEEVILLE, WI 53954-9125
(920) 627-3040
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
171449-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39931400
—
WI
Enumeration date
04/11/2008
Last updated
10/05/2015
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