Healthcare Provider Details

I. General information

NPI: 1447263843
Provider Name (Legal Business Name): SUSAN MARJORIE TOYAMA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 827 BOX 158
FPO AE
09617
US

IV. Provider business mailing address

PSC 827 BOX 158
FPO AE
09617
US

V. Phone/Fax

Practice location:
  • Phone: 011390818116404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License NumberRN00095981
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: