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General NPI Number Information
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NPI Number | 1770903114
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Entity Type | Individual
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Provider Name | SUSAN KAY CLAVETTE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 7171 W 95TH ST STE 210
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2249
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Country | US
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Telephone | 913-210-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 7171 W 95TH ST STE 210
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2249
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Country | US
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Telephone | 913-210-6005
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Fax | 913-210-6008
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 76322
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License Number State | KS
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