Provider Demographics
NPI:1710275482
Name:KUCHARO, SUSAN RAYE (RN CPNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:RAYE
Last Name:KUCHARO
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Gender:F
Credentials:RN CPNP
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Mailing Address - Street 1:222 W THOMAS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4419
Mailing Address - Country:US
Mailing Address - Phone:602-406-3522
Mailing Address - Fax:602-294-5129
Practice Address - Street 1:222 W THOMAS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4419
Practice Address - Country:US
Practice Address - Phone:602-406-3522
Practice Address - Fax:602-294-5129
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
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Provider Licenses
StateLicense IDTaxonomies
AZRN024405363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics