Individual provider Active NPI

Susan Kathryn Stolzenbach, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1528326451
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP60259853 Issued in WA
Practice address
1460 N 16TH Ave
Ste G
Yakima, WA 98902-7102
Phone
(509) 575-7760
Fax
(509) 575-7796
NPI assigned
Apr 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP60259853 WA Primary

Addresses

Primary practice location

1460 N 16TH Ave
Ste G
Yakima, WA 98902-7102

Mailing address

1460 N 16TH Ave
Ste G
Yakima, WA 98902-7102
Phone (509) 575-7760

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60259853WAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1335571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1528326451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N 16TH AVE",
            "address_2": "STE G",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027102",
            "telephone_number": "509-575-7760",
            "fax_number": "509-575-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 N 16TH AVE",
            "address_2": "STE G",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027102",
            "telephone_number": "509-575-7760",
            "fax_number": "509-575-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLZENBACH",
        "first_name": "SUSAN",
        "middle_name": "KATHRYN",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-28",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60259853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.