| Doctor Name: | SUZANNE O'ROURKE ROTHBERG |
| NPI Number: | 1205140043 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP |
| License Number: | 6592021-4408 |
| Business Practice Address: | 1906 W 3600 S West Valley City, UT - 841194715 |
| Business Phone Number: | 8019739675 |
| Business Fax Number: | |
| Mailing Address: | 1115 E 200 S, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841022503 |
| Phone Number: | 2182304108 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2010 |
| NPI Last Update Date: | 08/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 6592021-4408 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |