Susan Helen Bumpus, MSN, RN
Individual provider Active NPI Registered Nurse · Winslow, AZ
NPI 1366451817 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366451817
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN 095456 (AZ)
- Practice address
- 804 N Kinsley Ave
Winslow, AZ 86047-3630 - Phone
- (928) 289-1252
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN 095456 | AZ | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gentle Soles, Inc. | Registered Nurse | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN 095456 | AZ | Yes |
Addresses
Primary practice location
804 N Kinsley Ave
Winslow, AZ 86047-3630
Mailing address
804 N Kinsley Ave
Winslow, AZ 86047-3630
Phone (928) 289-1252
Other providers in Winslow, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.