Provider Demographics
NPI:1821693292
Name:SAUTER-JOHNSON, LEANN J (RN)
Entity Type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:J
Last Name:SAUTER-JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LEANN
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1001 MENASHA AVE E
Mailing Address - Street 2:
Mailing Address - City:LADYSMITH
Mailing Address - State:WI
Mailing Address - Zip Code:54848-1601
Mailing Address - Country:US
Mailing Address - Phone:715-505-7406
Mailing Address - Fax:
Practice Address - Street 1:1001 MENASHA AVE E
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-1601
Practice Address - Country:US
Practice Address - Phone:715-505-7406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI236847163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse