Susan L Bock, APNP
Individual provider Active NPI Nurse Practitioner · Onalaska, WI
NPI 1861496689 · NPPES record last updated May 28, 2019
Key facts
- NPI
- 1861496689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 2364 (WI)
- Practice address
- 191 Theater Rd
Onalaska, WI 54650-8679 - Phone
- (608) 392-5000
- NPI assigned
- Jun 9, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2364 | WI | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2364 | WI | |
| Nurse Practitioner | 363L00000X | 2364 | WI | Yes |
Addresses
Primary practice location
191 Theater Rd
Onalaska, WI 54650-8679
Mailing address
PO Box 1510
Eau Claire, WI 54702-1510
Phone (715) 838-5895
Other providers in Onalaska, WI
- Dustin Billups
- Bridget Natasha Bird I
- Daniel Craig Bird
- Katelyn Bjorge
- Benjamin Jelinek Boardman
- James Timothy Bodoh
- William Boisvert
- Kathleen L Bondow
- Jerome Paul Boortz
- Dileep Borra
All providers in Onalaska, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.