Provider Demographics
NPI:1760611750
Name:SEWELL, SUZANNE CHRISTINE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:CHRISTINE
Last Name:SEWELL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:CHRISTINE
Other - Last Name:TAMMEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:
Practice Address - Street 1:500 W THOMAS RD STE 850
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4218
Practice Address - Country:US
Practice Address - Phone:602-406-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ227094363LF0000X
CA18660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily