MEDICARE: DR. SUSAN S VANBEUGE A.P.N.

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
1	363LF0000X	Family Nurse Practitioner	APN000784	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	APN00742	OTHER	NV	PHARMACY/CDS

General Provider Information

NPI Number	:	1174501720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN S VANBEUGE A.P.N.

Provider Business Mailing Address
First Line	:	653 N TOWN CENTER DR
Second Line	:	SUITE 315
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0514
Country	:	US
Telephone Number	:	702-804-9486
Fax Number	:	702-802-3435

Provider Business Practice Location Address
First Line	:	653 N TOWN CENTER DR
Second Line	:	SUITE 315
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0514
Country	:	US
Telephone Number	:	702-804-9486
Fax Number	:	702-802-3435

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. SUSAN S VANBEUGE A.P.N.” Practice Location

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