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General NPI Number Information
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NPI Number | 1487145967
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Entity Type | Individual
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Provider Name | SUSAN MICHELLE ENGLEBERT DNP, WHNP-BC, CNM
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Gender | Female
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 2920 N 4TH ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-1816
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Country | US
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Telephone | 928-522-9400
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Fax | 928-522-9601
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Provider Business Mailing Address
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Address Line | PO BOX 3630
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City | FLAGSTAFF
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State | AZ
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Zip | 86003-3630
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Country | US
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Telephone | 928-522-9879
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 1653653
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APN.0999870-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 313886
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APN.0999871-CNM
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 313886
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License Number State | AZ
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