Provider Demographics
NPI:1245284363
Name:DARR, SUSANNA TURNER (APRN)
Entity type:Individual
Prefix:MRS
First Name:SUSANNA
Middle Name:TURNER
Last Name:DARR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:SUSANNA
Other - Middle Name:LOUISE
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1871 S 22ND AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7054
Mailing Address - Country:US
Mailing Address - Phone:406-404-6814
Mailing Address - Fax:406-205-1541
Practice Address - Street 1:1871 S 22ND AVE STE 3
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7054
Practice Address - Country:US
Practice Address - Phone:406-404-6814
Practice Address - Fax:406-205-1541
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4212357363LP0808X
MT36962363LP0808X
MT100772363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q47801Medicare UPIN