Provider Demographics
NPI:1942254958
Name:BURHAM, SUSAN A (CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:BURHAM
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:A
Other - Last Name:KARIMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:1215 DUFF AVENUE
Mailing Address - Street 2:MCFARLAND CLINIC, PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-4404
Mailing Address - Fax:515-239-4786
Practice Address - Street 1:1215 DUFF AVENUE
Practice Address - Street 2:MCFARLAND CLINIC PC
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-4404
Practice Address - Fax:515-239-4786
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB098743176B00000X
IAB-098743367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife