MEDICARE: MS. SUSAN ANN DAY M.S.

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	231H00000X	Audiologist	311	CO
2	231HA2400X	Assistive Technology Practitioner Audiologist	311	CO
3	231HA2500X	Assistive Technology Supplier Audiologist	311	CO
4	237600000X	Audiologist-Hearing Aid Fitter	311	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	311	OTHER	CO	COLORADO LICENSURE

General Provider Information

NPI Number	:	1457687824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN ANN DAY M.S.

Provider Business Mailing Address
First Line	:	343 SOUTH SAINT VRAIN AVE.
Second Line	:	UNIT 7
City	:	ESTES PARK
State	:	CO
Zip	:	80517-9751
Country	:	US
Telephone Number	:	970-577-1134
Fax Number	:	970-577-1164

Provider Business Practice Location Address
First Line	:	343 SOUTH SAINT VRAIN AVE.
Second Line	:	UNIT 7
City	:	ESTES PARK
State	:	CO
Zip	:	80517-9751
Country	:	US
Telephone Number	:	970-577-1134
Fax Number	:	970-577-1164

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

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	09/21/2015

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