Healthcare Provider Details

I. General information

NPI: 1437285418
Provider Name (Legal Business Name): SUSAN MARIE NEFF RN, MS, CS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 GAMMON PL SUITE 290
MADISON WI
53719-1045
US

IV. Provider business mailing address

402 GAMMON PL SUITE 290
MADISON WI
53719-1045
US

V. Phone/Fax

Practice location:
  • Phone: 608-833-9770
  • Fax: 608-833-1197
Mailing address:
  • Phone: 608-833-9770
  • Fax: 608-833-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number69996-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: