Provider Demographics
NPI:1841266293
Name:PARSONS, SUZANNE LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:LYNNE
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:LYNNE
Other - Last Name:DEVEREAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2345 BENT WAY
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-7614
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425915207Q00000X
CO46550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013335150001Medicaid
PA1013335150003Medicaid
CO19284OtherKAISER COMMERCIAL NUMBER
PA50047705OtherCAPITAL BLUE CROSS
PAP006743OtherGATEWAY HEALTH PLAN
PA7884679OtherAETNA NON-HMO
PA1013335150002Medicaid
PA106601 S1QJOtherGEISINGER HEALTH PLAN
PAI28204OtherHEALTH ASSURANCE
PAP00231228OtherRAILROAD MEDICARE
PA1114684OtherAETNA HMO
PA1746985OtherHIGHMARK BLUE SHIELD
CO14020777Medicaid
PAP00231228OtherRAILROAD MEDICARE
PA1114684OtherAETNA HMO
CO14020777Medicaid