Provider Demographics
NPI:1750318978
Name:SUTTON, MARTHA RUTH (CRNA)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:RUTH
Last Name:SUTTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7566N LA CHOLLA BLVD A
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2307
Mailing Address - Country:US
Mailing Address - Phone:520-742-4139
Mailing Address - Fax:520-742-9618
Practice Address - Street 1:7566N LA CHOLLA BLVD A
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2307
Practice Address - Country:US
Practice Address - Phone:520-742-4139
Practice Address - Fax:520-742-9618
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCRNA0160367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered