Provider Demographics
NPI:1407172950
Name:KEIPER, SUSAN JENNIFER (FNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JENNIFER
Last Name:KEIPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:JENNIFER
Other - Last Name:HARUFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 N STATE ST
Mailing Address - Street 2:INPATIENT TOWER C3C162
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1029
Mailing Address - Country:US
Mailing Address - Phone:323-409-3094
Mailing Address - Fax:323-441-8390
Practice Address - Street 1:2051 MARENGO ST
Practice Address - Street 2:C3C162
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1352
Practice Address - Country:US
Practice Address - Phone:323-409-3094
Practice Address - Fax:323-441-8390
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN313800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily