Provider Demographics
NPI:1508560574
Name:ONE LOVE, SUSANNE (RN)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:
Last Name:ONE LOVE
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 1:3103 TOHO TRL
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-3778
Mailing Address - Country:US
Mailing Address - Phone:928-856-9265
Mailing Address - Fax:
Practice Address - Street 1:1310 S 15TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-3826
Practice Address - Country:US
Practice Address - Phone:928-856-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN182849163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool