Individual
SUSAN G MOURS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
400 WOODLAND PRIME, N74W12501 LEATHERWOOD COURT, MENOMONEE FALLS, WI 53051-4490
(414) 777-0811
(414) 777-3529
Mailing address
W232N7970 NESTING CT, SUSSEX, WI 53089-5702
(262) 818-4228
(262) 653-5412
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
1038
WI
363LF0000X
Family Nurse Practitioner
Primary
1038-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43894500
—
WI
Enumeration date
05/27/2006
Last updated
11/06/2019
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