Doctor Name: | SUZANNE E MAZER |
NPI Number: | 1316219165 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 135259 |
Business Practice Address: | 1608 E Evergreen St Ste D Cameron, MO - 644292400 |
Business Phone Number: | 8166323945 |
Business Fax Number: | 8166323940 |
Mailing Address: | 1600 E Evergreen St, CAMERON |
State: | MO |
Postal Code: | 644292400 |
Phone Number: | 8166322101 |
Fax Number: | 8166493383 |
NPI Enumeration Date: | 02/08/2012 |
NPI Last Update Date: | 02/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 135259 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |