Provider Demographics
NPI:1013150325
Name:BEZNER, SUSAN BARBARA (ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BARBARA
Last Name:BEZNER
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 1:731 12TH AVE NW
Mailing Address - Street 2:SUITE #201
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-5761
Mailing Address - Country:US
Mailing Address - Phone:580-224-9000
Mailing Address - Fax:580-224-9009
Practice Address - Street 1:731 12TH AVE NW
Practice Address - Street 2:SUITE #201
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5761
Practice Address - Country:US
Practice Address - Phone:580-224-9000
Practice Address - Fax:580-224-9009
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0074306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily