Provider Demographics
NPI:1649254921
Name:MONTEI, SUSAN DENISE (RN-WHNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:DENISE
Last Name:MONTEI
Suffix:
Gender:F
Credentials:RN-WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1551 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRGROVE
Mailing Address - State:MI
Mailing Address - Zip Code:48733-9542
Mailing Address - Country:US
Mailing Address - Phone:989-895-4015
Mailing Address - Fax:989-892-2438
Practice Address - Street 1:1200 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5756
Practice Address - Country:US
Practice Address - Phone:989-895-4015
Practice Address - Fax:989-892-2438
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704117500363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health