Provider Demographics
NPI:1588612402
Name:MACDONALD, SUZANNE M (NP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:M
Last Name:MACDONALD
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Gender:F
Credentials:NP
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Mailing Address - Street 1:5055 E BROADWAY BLVD
Mailing Address - Street 2:ARIZONA COMMUNITY PHYSICIANS PC SUITE A-100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3640
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:5300 E ERICKSON DR STE 108
Practice Address - Street 2:DESERT STAR FAMILY HEALTH ARIZONA COMMUNITY PHYSICIANS
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2809
Practice Address - Country:US
Practice Address - Phone:520-721-5330
Practice Address - Fax:520-547-5743
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2010-02-26
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Provider Licenses
StateLicense IDTaxonomies
AZRN053987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P54942Medicare UPIN