Suzanne Marie Earl, APRN,BC,FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

074879 Issued in MO

Practice address

4900 St Hwy. 160
Suite 2
Theodosia, MO 65761-6539

Phone

(417) 273-2300

Fax

(417) 273-2316

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1104845072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 328",
            "address_2": "4900 ST. HWY 160 SUITE 2",
            "city": "THEODOSIA",
            "state": "MO",
            "postal_code": "657610328",
            "telephone_number": "417-273-2300",
            "fax_number": "417-273-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 ST HWY. 160",
            "address_2": "SUITE 2",
            "city": "THEODOSIA",
            "state": "MO",
            "postal_code": "657616539",
            "telephone_number": "417-273-2300",
            "fax_number": "417-273-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARL",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APRN,BC,FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "074879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427550306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynne Adair, SPEECH THERAPIST
• Court Square Pharmacy, Inc
• Douglas County Public Health Services Group, Inc.
• Tabitha Miranda Faust, CPM
• Lutie District. R-VI School
• Theodosia Medical Center

• Family Nurse Practitioner in Theodosia, MO
• Providers in Theodosia, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.