Provider Demographics
NPI:1245389287
Name:BURGER, SUSAN E (FNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:E
Last Name:BURGER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22110 ROSCOE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3845
Mailing Address - Country:US
Mailing Address - Phone:818-704-6696
Mailing Address - Fax:818-704-6896
Practice Address - Street 1:22110 ROSCOE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-3845
Practice Address - Country:US
Practice Address - Phone:818-704-6696
Practice Address - Fax:818-704-6896
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284738363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW10046Medicare ID - Type UnspecifiedMEDICARE