Provider Demographics
NPI:1003064304
Name:BATTLE, SUSAN RANAE (FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:RANAE
Last Name:BATTLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CENTERPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-8651
Mailing Address - Country:US
Mailing Address - Phone:541-214-6301
Mailing Address - Fax:855-510-1784
Practice Address - Street 1:5 CENTERPOINTE DR
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8651
Practice Address - Country:US
Practice Address - Phone:541-214-6301
Practice Address - Fax:855-510-1784
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18370363LF0000X
OR201050104NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily