Provider Demographics
NPI:1548383961
Name:YATES, SUSAN DORIS (RN, CRNFA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:DORIS
Last Name:YATES
Suffix:
Gender:F
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 S TRENTON CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5686
Mailing Address - Country:US
Mailing Address - Phone:303-755-5510
Mailing Address - Fax:303-755-7104
Practice Address - Street 1:1661 S TRENTON CT
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5686
Practice Address - Country:US
Practice Address - Phone:303-755-5510
Practice Address - Fax:303-755-7104
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO120412163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant