Individual
MRS. CHANTA SUSBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
4142 N 91ST STREET, APARTMENT 2, MILWAUKEE, WI 53222-1649
(414) 393-1389
Mailing address
4142 N. 91ST STREET, APARTMENT 2, MILWAUKEE, WI 53222-1649
(414) 393-1389
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
144593030
WI
Other
Enumeration date
04/14/2010
Last updated
04/14/2010
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