| Doctor Name: | SUSANNA FUNK |
| NPI Number: | 1598019663 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | G116903 |
| Business Practice Address: | 302 Ne 14th St Leon, IA - 501441206 |
| Business Phone Number: | 6414462382 |
| Business Fax Number: | |
| Mailing Address: | 302 Ne 14th St, LEON |
| State: | IA |
| Postal Code: | 501441206 |
| Phone Number: | 6414462382 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2012 |
| NPI Last Update Date: | 10/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | G116903 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |