Individual
SUSAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2697 HILLSIDE HEIGHTS DR, GREEN BAY, WI 54311-6774
(920) 471-7976
Mailing address
2697 HILLSIDE HEIGHTS DR, GREEN BAY, WI 54311-6774
(920) 471-7976
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314600
WI
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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