| Amanda Lee Suino-malcolm, APRN, CNP | |
|
13447 W County Road B, Hayward, WI 54843-2259 | |
| (715) 558-7883 | |
| (715) 558-7348 |
| Full Name | Amanda Lee Suino-malcolm |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 13447 W County Road B, Hayward, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356684880 | NPI | - | NPPES |
| 1356684880 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 141483-30 (Wisconsin) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5436-33 (Wisconsin) | Primary |
| Entity Name | Lac Courte Oreilles Governing Board |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194830208 PECOS PAC ID: 7810983517 Enrollment ID: O20040420001318 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Lee Suino-malcolm, APRN, CNP 13447 W County Road B, Hayward, WI 54843-2259 Ph: (715) 558-7883 | Amanda Lee Suino-malcolm, APRN, CNP 13447 W County Road B, Hayward, WI 54843-2259 Ph: (715) 558-7883 |
Ms. Tyra Jo Newman, APRN, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 11134 N State Road 77, Hayward, WI 54843 Phone: 715-634-5505 | |
Heidi Ruth Stangl, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11134 N Hwy 77, Hayward, WI 54843 Phone: 715-634-5505 | |
Amy Marie Hansen, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11040 N State Rd 77, Hayward, WI 54843 Phone: 715-934-4910 | |
Lisa M Gowey-fischer, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9086 W Moores Bay Rd, Hayward, WI 54843 Phone: 715-650-1332 | |
Miriam Amber Sward, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15954 Rivers Edge Dr, Hayward, WI 54843 Phone: 715-346-2541 Fax: 715-934-5090 | |
Matthew D Vincent, CRNA Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11040 N State Road 77, Hayward, WI 54843 Phone: 715-934-4321 | |
Michelle Lynn Lowe, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13380 W Trepania Rd, Hayward, WI 54843 Phone: 715-685-5100 Fax: 715-634-2740 |