Healthcare Provider Details

I. General information

NPI: 1376769166
Provider Name (Legal Business Name): SUSAN KAY HOHENBOKEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 E RIVERSIDE DR STE A-9
ST GEORGE UT
84790-6758
US

IV. Provider business mailing address

273 N 2830 E
ST GEORGE UT
84790-2498
US

V. Phone/Fax

Practice location:
  • Phone: 435-251-2888
  • Fax: 435-688-5239
Mailing address:
  • Phone: 435-688-9732
  • Fax: 435-688-5239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number357545-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: