Dr. Susanne Fine, LLC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

200870007CNS-PP Issued in OR

Legal business name

DR. SUSANNE FINE, LLC

Practice address

1117 E Main St
Suite 3
Medford, OR 97504-7404

Phone

(541) 245-1123

Fax

(541) 245-1123

NPI assigned

Dec 8, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Susanne Fine, PSY.D., RN, CNSNPI 1720062490

Title

Clinical Nurse Specialist/Arnp

Phone

(541) 245-1123

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susanne Fine, PSY.D., RN, CNS

  • Clinical Psychologist
  • Medford, OR
  • NPI 1720062490
  NPD (past) Authorized official

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1366427759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047404",
            "telephone_number": "541-245-1123",
            "fax_number": "541-245-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047404",
            "telephone_number": "541-245-1123",
            "fax_number": "541-245-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SUSANNE FINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-08",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "FINE",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_title_or_position": "CLINICAL NURSE SPECIALIST/ARNP",
        "authorized_official_telephone_number": "541-245-1123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., RN, CNS"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1546",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200870007CNS-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST",
            "identifier": "1546",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Clinical Nurse Specialist in Medford, OR
• Providers in Medford, OR by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.