Individual
SUSAN M THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF RADIATION ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-4400
(414) 805-4369
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF RADIATION ONCOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-4400
(414) 805-4369
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
141140
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912137126
—
WI
Enumeration date
07/22/2009
Last updated
10/29/2012
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