Provider Demographics
NPI:1952681157
Name:CARLIN, SUZY (RN,CDE)
Entity Type:Individual
Prefix:MS
First Name:SUZY
Middle Name:
Last Name:CARLIN
Suffix:
Gender:F
Credentials:RN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MYRANDA CT
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-1305
Mailing Address - Country:US
Mailing Address - Phone:505-474-9518
Mailing Address - Fax:877-859-9068
Practice Address - Street 1:2 MYRANDA CT
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-1305
Practice Address - Country:US
Practice Address - Phone:505-474-9518
Practice Address - Fax:877-859-9068
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR36652163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator