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NPI Code Detail

MEDICARE: MRS. SUSAN DUVAL ARNP, CRNFA

MEDICARE: MRS. SUSAN DUVAL ARNP, CRNFA
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 Practitioner3005974KY
2363LF0000XFamily Nurse Practitioner71004303AIN

General Provider Information

NPI Number : 1912958885
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN DUVAL ARNP, CRNFA
Provider Business Mailing Address
First Line : 695 3RD AVE
Second Line :
City : JASPER
State : IN
Zip : 47546-3602
Country : US
Telephone Number : 812-634-6824
Fax Number : 812-848-2277
Provider Business Practice Location Address
First Line : 695 3RD AVE
Second Line :
City : JASPER
State : IN
Zip : 47546-3602
Country : US
Telephone Number : 812-634-6824
Fax Number : 812-848-2277
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 11/13/2018

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