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NPI Code Detail

MEDICARE: SUSAN LOUELLA BOONE CNM

MEDICARE: SUSAN LOUELLA BOONE CNM
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
1367A00000XAdvanced Practice MidwifeAP112062TX

General Provider Information

NPI Number : 1649273111
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN LOUELLA BOONE CNM
Provider Business Mailing Address
First Line : 191 E PRICE RD
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78521-3527
Country : US
Telephone Number : 956-548-7400
Fax Number :
Provider Business Practice Location Address
First Line : 191 E PRICE RD
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78521-3527
Country : US
Telephone Number : 956-548-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 07/10/2025

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Directions to “ SUSAN LOUELLA BOONE CNM” Practice Location

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