Provider Demographics
NPI:1871859413
Name:FROST, SUSAN LYNNE (DNP, MC, FPMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LYNNE
Last Name:FROST
Suffix:
Gender:F
Credentials:DNP, MC, FPMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3345 N WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-2283
Mailing Address - Country:US
Mailing Address - Phone:928-445-5211
Mailing Address - Fax:928-776-8031
Practice Address - Street 1:3345 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2283
Practice Address - Country:US
Practice Address - Phone:928-445-5211
Practice Address - Fax:928-776-8031
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4406363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health