Provider Demographics
NPI:1477882827
Name:PREVILLE, ZSUZSANNA (PAC)
Entity Type:Individual
Prefix:
First Name:ZSUZSANNA
Middle Name:
Last Name:PREVILLE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 S RURAL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3793
Mailing Address - Country:US
Mailing Address - Phone:480-831-0600
Mailing Address - Fax:
Practice Address - Street 1:6655 S RURAL RD
Practice Address - Street 2:STE 3
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3793
Practice Address - Country:US
Practice Address - Phone:480-831-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant