Provider Demographics
NPI:1770903114
Name:CLAVETTE, SUSAN KAY (PMHNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:KAY
Last Name:CLAVETTE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7171 W 95TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-2249
Mailing Address - Country:US
Mailing Address - Phone:913-210-6005
Mailing Address - Fax:913-210-6008
Practice Address - Street 1:7171 W 95TH ST STE 210
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2249
Practice Address - Country:US
Practice Address - Phone:913-210-6005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76322363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health