Suzane Barbara Bazner, MSN, ANP

Individual provider Active NPI Adult Health Nurse Practitioner · Boston, MA

NPI 1780870337 · NPPES record last updated Sep 18, 2007

Key facts

NPI
1780870337
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
195852 (MA)
Practice address
55 Fruit St
Cox 626
Boston, MA 02114-2621
Phone
(617) 724-0070
Fax
(617) 643-2899
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
195852MAMDAdult Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 195852 MA Yes

Addresses

Primary practice location

55 Fruit St
Cox 626
Boston, MA 02114-2621

Mailing address

55 Fruit St
Cox 626
Boston, MA 02114-2621
Phone (617) 724-0070

Other providers in Boston, MA

All providers in Boston, MA · Adult Health Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.