Provider Demographics
NPI:1700918737
Name:KOEHLER, SUSAN L (NP MSN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:L
Last Name:KOEHLER
Suffix:
Gender:F
Credentials:NP MSN
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Other - First Name:
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Mailing Address - Street 1:1001 POTRERO AVE # 7E11
Mailing Address - Street 2:SFGH PSYCHIATRY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:415-206-5124
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE # 7E11
Practice Address - Street 2:SFGH PSYCHIATRY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-5124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN235894163WP2201X
CANP9584363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
993279OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER