Provider Demographics
NPI:1558699595
Name:ELLER, SUSAN SAMEE (NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:SAMEE
Last Name:ELLER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1250 S CLEARVIEW AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3378
Mailing Address - Country:US
Mailing Address - Phone:480-988-9108
Mailing Address - Fax:480-813-4460
Practice Address - Street 1:6501EAST GREENWAY PARKWAY
Practice Address - Street 2:SUITE 3-104
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2066
Practice Address - Country:US
Practice Address - Phone:480-948-3314
Practice Address - Fax:480-948-3588
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2015-04-03
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Provider Licenses
StateLicense IDTaxonomies
AZRN108183363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care