Provider Demographics
NPI:1952507147
Name:LUNN, SUZANNE MARIE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:MARIE
Last Name:LUNN
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 1:28811 GLEN RDG
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4301
Mailing Address - Country:US
Mailing Address - Phone:949-472-3683
Mailing Address - Fax:949-461-7706
Practice Address - Street 1:360 SAN MIGUEL DR
Practice Address - Street 2:SUITE 607
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7853
Practice Address - Country:US
Practice Address - Phone:949-459-3284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406146-1047163W00000X
CA406146163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery