Healthcare Provider Details

I. General information

NPI: 1174086300
Provider Name (Legal Business Name): SUHMER N FRYER NEMT , EDUCATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2019
Last Update Date: 04/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 BEECHCRAFT WAY
SACRAMENTO CA
95834-4000
US

IV. Provider business mailing address

PO BOX 294
DAVIS CA
95617-0294
US

V. Phone/Fax

Practice location:
  • Phone: 530-219-3070
  • Fax:
Mailing address:
  • Phone: 530-551-2182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: