Provider Demographics
NPI:1437665650
Name:SUSANNA DARR APRN PLLC
Entity Type:Organization
Organization Name:SUSANNA DARR APRN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:406-404-6814
Mailing Address - Street 1:1871 S. 22ND AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7054
Mailing Address - Country:US
Mailing Address - Phone:406-404-6814
Mailing Address - Fax:
Practice Address - Street 1:1871 S. 22ND AVE
Practice Address - Street 2:STE 3
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7054
Practice Address - Country:US
Practice Address - Phone:406-404-6814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty