Individual
GINA M SUCHOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 N US HIGHWAY 141, CRIVITZ, WI 54114-1708
(715) 854-3940
(715) 854-3941
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(715) 854-3940
(715) 854-3941
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
7658
WI
363LF0000X
Family Nurse Practitioner
7658-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067621
—
WI
01
—
473548414
TAX ID FOR AURORA BAY AREA MEDICAL GROUP
WI
Enumeration date
04/27/2017
Last updated
10/04/2023
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