Provider Demographics
NPI:1326278250
Name:ANDROSKI, SUSAN RAE (RN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:RAE
Last Name:ANDROSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 CATLIN AVE
Mailing Address - Street 2:BOX 3
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-5137
Mailing Address - Country:US
Mailing Address - Phone:715-304-2054
Mailing Address - Fax:715-394-9182
Practice Address - Street 1:2231 CATLIN AVE
Practice Address - Street 2:BOX 3
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-5137
Practice Address - Country:US
Practice Address - Phone:715-304-2054
Practice Address - Fax:715-394-9182
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI117186 - 030163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management