Healthcare Provider Details

I. General information

NPI: 1174567267
Provider Name (Legal Business Name): SUSAN SLIEF P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 S JACKSON ST
HUGOTON KS
67951-2858
US

IV. Provider business mailing address

203 WATSON ST STE 200
PRATT KS
67124-3092
US

V. Phone/Fax

Practice location:
  • Phone: 620-544-6122
  • Fax:
Mailing address:
  • Phone: 620-672-7422
  • Fax: 620-450-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-00531
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: