Provider Demographics
NPI:1952633281
Name:TWEEDY, SUSAN (CNA)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:TWEEDY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 S GLENCOE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1024
Mailing Address - Country:US
Mailing Address - Phone:303-757-8378
Mailing Address - Fax:
Practice Address - Street 1:3849 S GLENCOE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1024
Practice Address - Country:US
Practice Address - Phone:303-757-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO709976376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide