Individual
SUSAN K ETHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2000 N DEWEY AVE, REEDSBURG, WI 53959-1049
(608) 768-6255
(608) 524-0842
Mailing address
2000 N DEWEY AVE, REEDSBURG, WI 53959-1049
(608) 768-6255
(608) 524-0842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2407-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41183800
—
WI
Enumeration date
08/02/2005
Last updated
03/31/2008
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