Healthcare Provider Details

I. General information

NPI: 1801789326
Provider Name (Legal Business Name): CHIMBERLAINE PADAYAO SUAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHIMBERLAINE PADAYAO SUAN DNP

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 CATALPA CIR
MADISON WI
53713-2428
US

IV. Provider business mailing address

1111 CATALPA CIR
MADISON WI
53713-2428
US

V. Phone/Fax

Practice location:
  • Phone: 715-204-5541
  • Fax: 715-204-5541
Mailing address:
  • Phone: 715-204-5541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1108850-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: