=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760985543
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUEANN L RINGER FNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2018
-----------------------------------------------------
Last Update Date | 11/13/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3200 N DOBSON RD STE B-1
-----------------------------------------------------
City | CHANDLER
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85224-9608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-345-2488
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2737 W BASELINE RD STE 24
-----------------------------------------------------
City | TEMPE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85283-1051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-437-4800
-----------------------------------------------------
Fax | 602-437-4805
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP10889
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------