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General NPI Number Information
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NPI Number | 1205664794
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Entity Type | Individual
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Provider Name | SUSAN M CLOUGH NP
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Gender | Female
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 1000 SOUTHPARK DR
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City | LITTLETON
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State | CO
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Zip | 80120-5654
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Country | US
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Telephone | 303-744-1065
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Fax | 303-733-1699
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Provider Business Mailing Address
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Address Line | 1000 SOUTHPARK DR
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City | LITTLETON
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State | CO
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Zip | 80120-5654
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Country | US
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Telephone | 303-744-1065
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Fax | 303-733-1699
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0999983-NP
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License Number State | CO
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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 | APN.0999983-NP
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License Number State | CO
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