Provider Demographics
NPI:1700811726
Name:PARMENTER, SUSAN QUATTRINI (FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:QUATTRINI
Last Name:PARMENTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15571 N REEMS RD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9584
Mailing Address - Country:US
Mailing Address - Phone:623-544-6932
Mailing Address - Fax:623-321-1070
Practice Address - Street 1:15571 N REEMS RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9584
Practice Address - Country:US
Practice Address - Phone:623-544-6932
Practice Address - Fax:623-321-1070
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333022363LF0000X
AZAP4488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02356045Medicaid
P10170Medicare UPIN
NYDD6558Medicare ID - Type UnspecifiedINDIVIDUAL ID#
NY02356045Medicaid