Provider Demographics
NPI:1972593689
Name:EVERS, SUSAN T (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:T
Last Name:EVERS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:BADGER
Mailing Address - State:IA
Mailing Address - Zip Code:50516-7511
Mailing Address - Country:US
Mailing Address - Phone:515-545-4243
Mailing Address - Fax:
Practice Address - Street 1:1005 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:BADGER
Practice Address - State:IA
Practice Address - Zip Code:50516-7511
Practice Address - Country:US
Practice Address - Phone:515-545-4243
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF-051368363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
16217Medicare ID - Type Unspecified
PO1093Medicare UPIN