MEDICARE: DR. SUZANNE KRISTEN PURYEAR DNP-FNP

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	202108794NP-PP	OR

General Provider Information

NPI Number	:	1215607890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE KRISTEN PURYEAR DNP-FNP

Provider Business Mailing Address
First Line	:	211 NW LARCH AVE # 478
Second Line	:
City	:	REDMOND
State	:	OR
Zip	:	97756-1357
Country	:	US
Telephone Number	:	541-548-2164
Fax Number	:

Provider Business Practice Location Address
First Line	:	2255 NW SHEVLIN PARK RD STE 110
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-7134
Country	:	US
Telephone Number	:	541-728-2525
Fax Number	:	503-917-4971

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

Provider Enumeration Date	:	09/15/2021
Last Update Date	:	02/05/2026

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