Healthcare Provider Details

I. General information

NPI: 1982974275
Provider Name (Legal Business Name): SUSAN GENTHNER FLOYD DNP, CRNP, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 S MOORLAND RD FL 3
NEW BERLIN WI
53151-7494
US

IV. Provider business mailing address

7237 BRAE CT
GURNEE IL
60031-4485
US

V. Phone/Fax

Practice location:
  • Phone: 262-432-7599
  • Fax:
Mailing address:
  • Phone: 919-604-7067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number277003538
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number15949-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: