Healthcare Provider Details

I. General information

NPI: 1992804447
Provider Name (Legal Business Name): SUE ASHER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 MENA ST
MENA AR
71953-4280
US

IV. Provider business mailing address

1201 MENA ST
MENA AR
71953-4280
US

V. Phone/Fax

Practice location:
  • Phone: 479-394-2332
  • Fax: 479-437-3708
Mailing address:
  • Phone: 479-394-2332
  • Fax: 479-437-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN142933 NP
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN142933 NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: