Provider Demographics
NPI:1184147175
Name:MILNE, SUZANNE (NP)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:
Last Name:MILNE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E SOUTH TEMPLE APT 520
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-1264
Mailing Address - Country:US
Mailing Address - Phone:248-882-8515
Mailing Address - Fax:
Practice Address - Street 1:5171 S COTTONWOOD ST STE 350
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-5733
Practice Address - Country:US
Practice Address - Phone:801-507-7781
Practice Address - Fax:801-507-7780
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8995591-8900363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care