Provider Demographics
NPI:1376571778
Name:TARNO, SUZZAN M (CRNP)
Entity Type:Individual
Prefix:
First Name:SUZZAN
Middle Name:M
Last Name:TARNO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SUZZAN
Other - Middle Name:M
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3815 E BELL RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2139
Mailing Address - Country:US
Mailing Address - Phone:602-633-3838
Mailing Address - Fax:
Practice Address - Street 1:10815 W MCDOWELL RD STE 202
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5010
Practice Address - Country:US
Practice Address - Phone:623-433-0202
Practice Address - Fax:623-433-0204
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-084184363L00000X
WI229776363LA2100X
AZ247230363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner