Healthcare Provider Details

I. General information

NPI: 1023433950
Provider Name (Legal Business Name): SUZANNA KUZNETZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUZANNA KUZNETZ RND

II. Dates (important events)

Enumeration Date: 03/01/2014
Last Update Date: 03/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4717 S PITTSBURG ST
SPOKANE WA
99223-6556
US

IV. Provider business mailing address

4717 S PITTSBURG ST
SPOKANE WA
99223-6556
US

V. Phone/Fax

Practice location:
  • Phone: 509-879-1372
  • Fax: 509-448-3691
Mailing address:
  • Phone: 509-879-1372
  • Fax: 509-448-3691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00060548
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: