Healthcare Provider Details

I. General information

NPI: 1831589977
Provider Name (Legal Business Name): SUZANNE FOX PNP, PMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 E BELLEVIEW AVE STE 300
GREENWOOD VILLAGE CO
80111-1629
US

IV. Provider business mailing address

30 W RAMPART ST SUITE 170
SHELBYVILLE IN
46176-8846
US

V. Phone/Fax

Practice location:
  • Phone: 303-468-8018
  • Fax:
Mailing address:
  • Phone: 317-398-7337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number28206432A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number28206432C
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number28206432A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0003511-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: