Provider Demographics
NPI:1346234481
Name:HOWELL, SUSAN M (CRNA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:HOWELL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:JANKURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:9692 E SUMMIT LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-3159
Mailing Address - Country:US
Mailing Address - Phone:502-649-5442
Mailing Address - Fax:
Practice Address - Street 1:8901 E RAINTREE DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-767-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1072874163W00000X
IN28113678A163W00000X
AZRN149170163W00000X
KY2192A367500000X
AZCRNA0547367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ284352Medicaid
IN200254020Medicaid
KY74463456Medicaid
AZ1346234481OtherBCBS
AZZ125302Medicare PIN
KY0983401Medicare Oscar/Certification
IN200254020Medicaid
IN232380LMedicare Oscar/Certification
KY74463456Medicaid