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General NPI Number Information
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NPI Number | 1023422342
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Entity Type | Individual
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Provider Name | SUSAN CLOSE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 901 NE RIVER RD
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City | TOPEKA
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State | KS
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Zip | 66616-1142
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Country | US
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Telephone | 660-679-1301
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Fax |
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Provider Business Mailing Address
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Address Line | 2614 RIDGEWOOD RD
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City | HARRISONVILLE
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State | MO
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Zip | 64701-4206
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Country | US
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Telephone | 660-679-1301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2014004539
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-76317-091
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License Number State | KS
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