Healthcare Provider Details

I. General information

NPI: 1881714582
Provider Name (Legal Business Name): SUSAN M JOYCE CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 W KINNICKINNIC RIVER PKWY SUITE 440
MILWAUKEE WI
53215-3669
US

IV. Provider business mailing address

36500 AURORA DR SUITE 200
SUMMIT WI
53066-4899
US

V. Phone/Fax

Practice location:
  • Phone: 414-385-2883
  • Fax: 414-385-4436
Mailing address:
  • Phone: 262-434-7362
  • Fax: 262-434-7351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number2596-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: