Provider Demographics
NPI:1427393321
Name:VIEGAS, SUSAN LORRAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LORRAINE
Last Name:VIEGAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NW SINCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-3363
Mailing Address - Country:US
Mailing Address - Phone:541-218-0056
Mailing Address - Fax:
Practice Address - Street 1:100 NW SINCLAIR DR
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3363
Practice Address - Country:US
Practice Address - Phone:541-218-0056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR097006524RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health