Provider Demographics
NPI:1194001826
Name:MCDANELD, SUSAN ROXANN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ROXANN
Last Name:MCDANELD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 MAINE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1368
Mailing Address - Country:US
Mailing Address - Phone:785-843-0721
Mailing Address - Fax:785-843-2930
Practice Address - Street 1:200 MAINE ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1368
Practice Address - Country:US
Practice Address - Phone:785-843-0721
Practice Address - Fax:785-843-2930
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS74098364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health