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Individual

MRS. BILLINA SUSANNE AUGUSTIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4800
(920) 965-4801
Mailing address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4800
(920) 965-4801

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1142-023
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42981300
WI
Enumeration date
02/16/2007
Last updated
12/16/2011
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