Perez, Susan J
Perez, Susan J is an individual health care provider with primary practice located at 1244 Wisconsin Ave , Racine WI 53403-1987. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Perez, Susan J can be contacted via phone (262) 687-2273.Contact Information
Primary practice address
1244 Wisconsin Ave
Racine WI 53403-1987
Phone: (262) 687-2273
Fax: (262) 687-2014
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2295023 | Wisconsin |
Profile Details
| NPI number | 1679720312 |
|---|---|
| LBN Legal business name | Perez, Susan J |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2008 |
| Last updated | Sep 14th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679720312 | NPPES |
| Wisconsin | MEDICAID | 1679720312 |
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