Provider Demographics
NPI:1720635022
Name:LAINSON, SUSAN JEAN
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JEAN
Last Name:LAINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 W NEOSHA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-9796
Mailing Address - Country:US
Mailing Address - Phone:520-743-7414
Mailing Address - Fax:
Practice Address - Street 1:2929 W NEOSHA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-9796
Practice Address - Country:US
Practice Address - Phone:520-743-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider