Provider Demographics
NPI:1417049784
Name:PERCHEMLIDES, SUE EVANS (RN,CS)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:EVANS
Last Name:PERCHEMLIDES
Suffix:
Gender:F
Credentials:RN,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2400 MATHEWS ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1707
Mailing Address - Country:US
Mailing Address - Phone:970-482-1126
Mailing Address - Fax:970-224-1588
Practice Address - Street 1:1100 POUDRE RIVER DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3500
Practice Address - Country:US
Practice Address - Phone:970-407-7439
Practice Address - Fax:970-224-1588
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAMA178174/PC363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health