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General NPI Number Information
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NPI Number | 1275842247
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Entity Type | Individual
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Provider Name | SUSAN MAUREEN SEGLIE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 2711 S ROUSE ST STE E
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City | PITTSBURG
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State | KS
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Zip | 66762-6621
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Country | US
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Telephone | 620-232-2890
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Fax | 620-232-5819
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Provider Business Mailing Address
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Address Line | 2711 S ROUSE ST STE E
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City | PITTSBURG
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State | KS
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Zip | 66762-6621
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Country | US
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Telephone | 620-232-2890
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Fax | 620-232-5819
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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 | 45014
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License Number State | KS
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