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Susan S Park, PNP
Pediatric Nurse Practitioner in Phoenix, Arizona
NPI 1548461221

Susan S Park is a Pediatric Nurse Practitioner based in Phoenix, AZ and is specialized in Pediatrics. Susan S Park practices in Phoenix, AZ and has the professional credentials of PNP. The NPI Number for Susan S Park is 1548461221 and holds a License No. 583996 (Arizona).

The current practice location address for Susan S Park is 1919 E Thomas Rd, Phoenix, AZ and can be reached out via phone at 602-933-3366 and via fax at 602-933-4166.

Location: 1919 E Thomas Rd, Phoenix, AZ, 85018-2327
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Provider Profile Details
NPI Number
1548461221
Provider Name
Susan S Park
Credential
PNP
Provider Entity Type
Individual
Gender
Female
Address
1919 E Thomas Rd, Phoenix, AZ, 85018-2327
Phone Number
602-933-3366
Fax Number
602-933-4166
Provider Enumeration Date
05/30/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
471651 05 AZ
institution
Provider Business Practice Location Address Details
Address
1919 E Thomas Rd
City
State
Zip
85016-7710
Phone Number
602-933-3366
Fax Number
602-933-4166
person
Provider Business Mailing Address Details
Address
1919 E Thomas Rd
City
State
Zip
85016-7710
Phone Number
602-933-3366
Fax Number
602-933-4166
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
583996 (New York)
Definition
Definition to come...
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