Provider Demographics
NPI:1811762644
Name:SUAREZ, SUSANA (BSR, RN)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:BSR, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 INCA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4421
Mailing Address - Country:US
Mailing Address - Phone:385-477-7358
Mailing Address - Fax:
Practice Address - Street 1:3525 W OXFORD AVE UNIT G-3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80236-3115
Practice Address - Country:US
Practice Address - Phone:303-315-6159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN1661231163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse