Ethun, Susan K

Ethun, Susan K is an individual health care provider with primary practice located at 2000 N Dewey Ave , Reedsburg WI 53959-1049. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Ethun, Susan K can be contacted via phone (608) 768-6255.

Contact Information

Primary practice address
2000 N Dewey Ave Reedsburg WI 53959-1049
Phone: (608) 768-6255
Fax: (608) 524-0842
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 2407-033 Wisconsin

Profile Details

NPI number 1821099813
LBN Legal business name Ethun, Susan K
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Mar 31st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821099813 NPPES
Wisconsin MEDICAID 41183800

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