| Doctor Name: | SUSSY A GONZALEZ |
| NPI Number: | 1265787030 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNFA, ANP-C |
| License Number: | 707614 |
| Business Practice Address: | 181 W Meadow Dr Suite 400 Vail, CO - 816575242 |
| Business Phone Number: | 9704761100 |
| Business Fax Number: | 9704795835 |
| Mailing Address: | 181 W Meadow Dr, Suite 400 VAIL |
| State: | CO |
| Postal Code: | 816575242 |
| Phone Number: | 9704761100 |
| Fax Number: | 9704795835 |
| NPI Enumeration Date: | 07/18/2012 |
| NPI Last Update Date: | 10/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 707614 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |