Provider Demographics
NPI:1508912643
Name:HARP, SUSAN BERYL (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:BERYL
Last Name:HARP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:402 N 4TH STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901
Mailing Address - Country:US
Mailing Address - Phone:509-248-3782
Mailing Address - Fax:509-545-6275
Practice Address - Street 1:1608 N ROAD 44
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-2667
Practice Address - Country:US
Practice Address - Phone:509-543-9280
Practice Address - Fax:509-545-6275
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP 60125623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP 60125623OtherSTATE OF WASHINGTON BOARD OF NURSING