Susie Palmer

Individual provider Active NPI School Registered Nurse · Aztec, NM

NPI 1063950293 · NPPES record last updated Feb 8, 2017

Key facts

NPI
1063950293
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
RN-77802 (NM)
Practice address
455 N Light Plant Rd
Aztec, NM 87410-1517
Phone
(505) 334-6102
Fax
(505) 599-4385
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN-77802NMMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN-77802 NM Yes

Addresses

Primary practice location

455 N Light Plant Rd
Aztec, NM 87410-1517

Mailing address

455 N Light Plant Rd
Aztec, NM 87410-1517
Phone (505) 334-6102

Other providers in Aztec, NM

All providers in Aztec, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.