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General NPI Number Information
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NPI Number | 1326316019
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Entity Type | Individual
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Provider Name | SUSAN DEERING ACNP
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Gender | Female
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 900 W MAGNOLIA AVE STE 100
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City | FORT WORTH
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State | TX
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Zip | 76104-8517
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Country | US
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Telephone | 817-870-7300
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Fax | 817-335-9529
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Provider Business Mailing Address
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Address Line | PO BOX 35629
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City | DALLAS
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State | TX
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Zip | 75235-0629
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Country | US
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Telephone | 214-424-2200
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Fax | 214-231-2159
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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 | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 632014
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License Number State | TX
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