Goranson, Nancy Jean

Goranson, Nancy Jean is an individual health care provider with primary practice located at 11101 W Lincoln Ave Rogers Memorial Hospital, West Allis WI 53227-1133. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Goranson, Nancy Jean can be contacted via phone (414) 203-4480.

Contact Information

Primary practice address
11101 W Lincoln Ave Rogers Memorial Hospital West Allis WI 53227-1133
Phone: (414) 203-4480
Fax: (414) 328-3737
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1624 Wisconsin

Profile Details

NPI number 1245223742
LBN Legal business name Goranson, Nancy Jean
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Jul 8th, 2007 - about 19 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 1245223742 NPPES
Wisconsin MEDICAID 39131400

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