Healthcare Provider Details

I. General information

NPI: 1528078151
Provider Name (Legal Business Name): SUSAN THERESE BARNES RN CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3522 N 3RD AVE
PHOENIX AZ
85013
US

IV. Provider business mailing address

3522 N 3RD AVE
PHOENIX AZ
85013
US

V. Phone/Fax

Practice location:
  • Phone: 602-266-8463
  • Fax:
Mailing address:
  • Phone: 602-266-8463
  • Fax: 602-230-4996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN022512
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN022512
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: