Provider Demographics
NPI:1982942033
Name:ESMAY, SUSAN KAY (BSN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KAY
Last Name:ESMAY
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:KAY
Other - Last Name:MOLSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN
Mailing Address - Street 1:1507 ROSALIE LN
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-2926
Mailing Address - Country:US
Mailing Address - Phone:920-660-1990
Mailing Address - Fax:
Practice Address - Street 1:1507 ROSALIE LN
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-2926
Practice Address - Country:US
Practice Address - Phone:920-660-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI68587-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse