Provider Demographics
NPI:1114999802
Name:GARBER, SUE (NP)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:GARBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 E BLANCHE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2229
Mailing Address - Country:US
Mailing Address - Phone:602-482-3255
Mailing Address - Fax:
Practice Address - Street 1:13203 N 103RD AVE
Practice Address - Street 2:SUITE I-1
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3028
Practice Address - Country:US
Practice Address - Phone:623-875-6580
Practice Address - Fax:623-974-8413
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAPN0849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP41630Medicare UPIN