Provider Demographics
NPI:1548563562
Name:BARNCARD, SUSAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BARNCARD
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 E BECKER RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-2422
Mailing Address - Country:US
Mailing Address - Phone:715-207-0274
Mailing Address - Fax:
Practice Address - Street 1:2511 E BECKER RD
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-2422
Practice Address - Country:US
Practice Address - Phone:715-207-0274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI169052163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse