Provider Demographics
NPI:1659958502
Name:TESTERMAN, SUSAN LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
Last Name:TESTERMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7504 NW 73RD PL
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-4438
Mailing Address - Country:US
Mailing Address - Phone:816-728-9981
Mailing Address - Fax:
Practice Address - Street 1:10940 PARALLEL PKWY STE K152
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-4434
Practice Address - Country:US
Practice Address - Phone:816-482-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021011107363LF0000X
KS53-80152-032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily