Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 141322 | WI |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 6609 | WI |
NPI | 1003285511 |
---|---|
Provider Name | Julie Sonsalla |
First Address | La Crosse, WI 54601-5429 |
Second Address | La Crosse, WI 54601-5429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 23/11/2015 |