Individual
MS. SUSAN E DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
N6716 LAKE LORRAINE RD, DELAVAN, WI 53115-2503
(608) 883-2176
Mailing address
N6716 LAKE LORRAINE RD, DELAVAN, WI 53115-2503
(608) 883-2176
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309441031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35059300
—
WI
Enumeration date
05/16/2008
Last updated
05/16/2008
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