White, Suzan L

White, Suzan L is an individual health care provider with primary practice located at 1 S Main St , Janesville WI 53545-3977. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Nursing Service Providers / Registered Nurse. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. White, Suzan L can be contacted via phone (608) 757-0404.

Contact Information

Primary practice address
1 S Main St Janesville WI 53545-3977
Phone: (608) 757-0404
Fax: (608) 757-2319
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3543-125 Wisconsin
Nursing Service Providers / Registered Nurse 163W00000X 80451-030 Wisconsin

Profile Details

NPI number 1891845707
LBN Legal business name White, Suzan L
Credentials MS
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Jul 8th, 2007 - 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 1891845707 NPPES
Wisconsin MEDICAID 43704400
Wisconsin Other 76707

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