Healthcare Provider Details

I. General information

NPI: 1568264158
Provider Name (Legal Business Name): CYDNEY SUZANNE LEVANETZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E CAMPUS MALL
MADISON WI
53715-1365
US

IV. Provider business mailing address

361 HALLMARK WAY
SUN PRAIRIE WI
53590-9219
US

V. Phone/Fax

Practice location:
  • Phone: 608-265-5600
  • Fax:
Mailing address:
  • Phone: 608-225-0320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number219870-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: