Provider Demographics
NPI:1811227069
Name:DUNCAN, SUSAN LYNN (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
Last Name:DUNCAN
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 1:1439 E MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-7017
Mailing Address - Country:US
Mailing Address - Phone:714-309-2774
Mailing Address - Fax:714-744-8681
Practice Address - Street 1:1439 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-7017
Practice Address - Country:US
Practice Address - Phone:714-309-2774
Practice Address - Fax:714-744-8681
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276323163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care