Healthcare Provider Details

I. General information

NPI: 1770402059
Provider Name (Legal Business Name): SUZANNE ELIZABETH MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 11TH AVE
TWO HARBORS MN
55616-1300
US

IV. Provider business mailing address

1531 CLOVER VALLEY DR
DULUTH MN
55804-9616
US

V. Phone/Fax

Practice location:
  • Phone: 218-834-7300
  • Fax:
Mailing address:
  • Phone: 218-481-2022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR-1570157
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: