Provider Demographics
NPI:1477706240
Name:PERRYMAN, SUZANNA M (RN)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:M
Last Name:PERRYMAN
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:P.O. BOX 1048
Mailing Address - Street 2:407 W 6TH
Mailing Address - City:WHITE DEER
Mailing Address - State:TX
Mailing Address - Zip Code:79097-1048
Mailing Address - Country:US
Mailing Address - Phone:806-231-9199
Mailing Address - Fax:806-883-4035
Practice Address - Street 1:7007 COVENANT LN
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-6880
Practice Address - Country:US
Practice Address - Phone:806-231-9199
Practice Address - Fax:806-883-4035
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX624910163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse