Healthcare Provider Details

I. General information

NPI: 1033480587
Provider Name (Legal Business Name): JANET SUSAN VROMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2012
Last Update Date: 01/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 LEGION PL
OSHKOSH WI
54901-5305
US

IV. Provider business mailing address

347 LEGION PL
OSHKOSH WI
54901-5305
US

V. Phone/Fax

Practice location:
  • Phone: 920-426-0192
  • Fax: 920-426-0192
Mailing address:
  • Phone: 920-426-0192
  • Fax: 920-426-0192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number111475-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: