Doctor Name: | SUSAN MADER |
NPI Number: | 1083751267 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 203455-3102 |
Business Practice Address: | 33 N 300 E Cedar City, UT - 847202620 |
Business Phone Number: | 4355866654 |
Business Fax Number: | 4359868700 |
Mailing Address: | 474 W 200 N, Suite 300 ST GEORGE |
State: | UT |
Postal Code: | 847704505 |
Phone Number: | 4356345600 |
Fax Number: | 4359868700 |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 203455-3102 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |