Provider Demographics
NPI:1659702744
Name:DRUCKER, SUSAN DIANE (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DIANE
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SE 7TH CIR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-6717
Mailing Address - Country:US
Mailing Address - Phone:405-473-5592
Mailing Address - Fax:
Practice Address - Street 1:309 SE 7TH CIR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-6717
Practice Address - Country:US
Practice Address - Phone:405-473-5592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0057741163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management