Provider Demographics
NPI:1629473251
Name:NAVARRO, SUSAN M
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1070
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02722-1070
Mailing Address - Country:US
Mailing Address - Phone:508-676-3292
Mailing Address - Fax:508-672-7181
Practice Address - Street 1:289 PLEASANT STREET STE 501
Practice Address - Street 2:PRIMA CARE, PC
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-676-3292
Practice Address - Fax:508-672-7181
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN 237859363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health