| Organization Name: | COREY SUTTER FNP |
| NPI Number: | 1023293990 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COREY SUTTER (FNP) |
| Mailing Address: | 2019 Galisteo St Ste J-1 Santa Fe |
| State: | NM US |
| Postal Code: | 875052143 |
| Phone Number: | 5058200446 |
| Fax Number: | 5058206142 |
| NPI Enumeration Date: | 01/09/2008 |
| NPI Last Update Date: | 05/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R29804 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |