Provider Demographics
NPI:1477030427
Name:COCORES, SUSAN LYNN (APRN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNN
Last Name:COCORES
Suffix:
Gender:F
Credentials:APRN
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1559 WATASHEAMU RD
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-7455
Mailing Address - Country:US
Mailing Address - Phone:775-265-8622
Mailing Address - Fax:775-265-3429
Practice Address - Street 1:1559 WATASHEAMU RD
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89460-7455
Practice Address - Country:US
Practice Address - Phone:775-265-8622
Practice Address - Fax:775-265-3429
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV811870363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner