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General NPI Number Information
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NPI Number | 1720537541
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Entity Type | Individual
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Provider Name | SUZETTE KANE
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Gender | Female
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 2000 BOISE AVE
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City | LOVELAND
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State | CO
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Zip | 80538-5006
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Country | US
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Telephone | 970-820-4640
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Fax |
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Provider Business Mailing Address
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Address Line | 4470 S. LEMAY AVE APT 515
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City | FORT COLLINS
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State | CO
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Zip | 80525
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0102834
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License Number State | CO
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