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NPI Code Detail

MEDICARE: MS. SUSAN LYNN GOHN RN

MEDICARE:  MS. SUSAN LYNN GOHN  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse760225CA

General Provider Information

NPI Number : 1033441035
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN LYNN GOHN RN
Provider Business Mailing Address
First Line : 8017 BLACK WALNUT CT
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-4603
Country : US
Telephone Number : 916-716-5521
Fax Number :
Provider Business Practice Location Address
First Line : 8017 BLACK WALNUT CT
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-4603
Country : US
Telephone Number : 916-716-5521
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2010
Last Update Date : 11/18/2013

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