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NPI Code Detail

MEDICARE: MS. SUZANNE E CARMODY FNP

MEDICARE: MS. SUZANNE E CARMODY 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
1363LF0000XFamily Nurse Practitioner94395CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
294395OTHERCOSTATE LICENSE

General Provider Information

NPI Number : 1326041443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUZANNE E CARMODY FNP
Provider Business Mailing Address
First Line : 2303 S TOWNSEND AVE STE A
Second Line :
City : MONTROSE
State : CO
Zip : 81401-5452
Country : US
Telephone Number : 970-249-7751
Fax Number : 970-249-5029
Provider Business Practice Location Address
First Line : 3330 S RIO GRANDE AVE STE 300
Second Line :
City : MONTROSE
State : CO
Zip : 81401-4850
Country : US
Telephone Number : 970-249-7751
Fax Number : 970-249-5029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 11/25/2024

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