Provider Demographics
NPI:1437325016
Name:MCNITT, SUSAN L (ANP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:MCNITT
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S PEORIA ST
Mailing Address - Street 2:#100
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5476
Mailing Address - Country:US
Mailing Address - Phone:314-620-6600
Mailing Address - Fax:
Practice Address - Street 1:1400 S POTOMAC ST
Practice Address - Street 2:#150
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4528
Practice Address - Country:US
Practice Address - Phone:303-306-4321
Practice Address - Fax:303-306-4347
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO153290363LF0000X
CO0202990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82007349Medicaid