Healthcare Provider Details

I. General information

NPI: 1659603082
Provider Name (Legal Business Name): SUZANNE THORP RNC, MS, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1284 S ABILENE ST
AURORA CO
80012-4629
US

IV. Provider business mailing address

179 SPRUCE WAY
BLACK HAWK CO
80422-8818
US

V. Phone/Fax

Practice location:
  • Phone: 303-671-7526
  • Fax: 303-671-7544
Mailing address:
  • Phone: 303-396-3426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberCNP-02375
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number82542
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: