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General NPI Number Information
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NPI Number | 1790772606
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Entity Type | Individual
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Provider Name | SUSAN R. BOND RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 104 S DR J B RIGGS DR
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City | GROESBECK
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State | TX
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Zip | 76642-1703
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Country | US
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Telephone | 254-729-3356
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Fax | 254-729-3489
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Provider Business Mailing Address
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Address Line | 330 SEVEN SPRINGS WAY
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City | BRENTWOOD
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State | TN
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Zip | 37027-5098
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Country | US
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Telephone | 615-920-7000
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Fax | 615-920-8775
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 449415
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License Number State | TX
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