Provider Demographics
NPI:1245245778
Name:ECKWRIGHT, SUSAN RAQUEL (APNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:RAQUEL
Last Name:ECKWRIGHT
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:RAQUEL
Other - Last Name:MARKFELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8739 COUNTY HIGHWAY S SOUTH
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-5230
Mailing Address - Country:US
Mailing Address - Phone:715-720-1231
Mailing Address - Fax:
Practice Address - Street 1:2509 COUNTY HIGHWAY I
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-2785
Practice Address - Country:US
Practice Address - Phone:715-717-4944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2753-033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily