Most Relevant Information
Provider Data
| NPI Number: | 1003313610 |
| Provider Name: | SUSAN CAROL SORRENTINO RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WA0400X |
| Specialty: | Registered Nurse |
| License Number: | 122943 |
Most Important Dates
| Enumeration Date: | 04/10/2018 |
| Last Updated: | 04/10/2018 |
Provider Practice Location
1836 SOUTH AVE
LA CROSSE
WI
546015429
Practice Location Phone/Fax
| Phone: | 6087827300 |
| Fax: |
Provider Mailing Location
1836 SOUTH AVE
LA CROSSE
WI
546015429
Provider Mailing Phone/Fax
| Phone: | 6087827300 |
| Fax: |