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General NPI Number Information
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NPI Number | 1942330659
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Entity Type | Individual
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Provider Name | SUSAN HARVEY FNP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 500 INDIANA AVE
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City | WINSLOW
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State | AZ
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Zip | 86047-2169
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Country | US
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Telephone | 928-289-4646
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Fax | 928-289-6290
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Provider Business Mailing Address
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Address Line | 500 INDIANA AVE
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City | WINSLOW
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State | AZ
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Zip | 86047-2169
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Country | US
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Telephone | 928-289-4646
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Fax | 928-289-6290
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN102235
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License Number State | AZ
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