Provider Demographics
NPI:1326017187
Name:LAPONSIE, SUSAN M (NP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:LAPONSIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12520 E TANQUE VERDE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8933
Mailing Address - Country:US
Mailing Address - Phone:520-749-4690
Mailing Address - Fax:
Practice Address - Street 1:5659 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2211
Practice Address - Country:US
Practice Address - Phone:520-751-4321
Practice Address - Fax:520-751-4640
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN029118363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS50673Medicare UPIN