Provider Demographics
NPI:1508694456
Name:OAKLEY, SUSAN MITCHELL (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MITCHELL
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:KUMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 ZIRCON DR TRLR 4
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-9631
Mailing Address - Country:US
Mailing Address - Phone:386-212-5266
Mailing Address - Fax:
Practice Address - Street 1:10345 PROFESSIONAL CIR STE 125A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-3100
Practice Address - Country:US
Practice Address - Phone:775-348-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN99230163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health