Susan Packer, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

233405 Issued in AZ

Practice address

174 W Highway 287
Florence, AZ 85132

Phone

(520) 868-5811

Fax

(520) 868-1223

NPI assigned

Nov 19, 2019

Last updated

Aug 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

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

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ, Nurse Practitioner

  Medicare reassignment NPD
• Sun Life Family Health Center, Inc

  dba Sun Life Center for Children

  • Federally Qualified Health Center (FQHC)
  • Casa Grande, AZ
  • NPI 1417286568
  NPD (past)
• Sun Life Family Health Center, Inc.

  dba Sun Life Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1508276940
  NPD (past)
• Sun Life Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Maricopa, AZ
  • NPI 1881073443
  NPD (past)

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1922644533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446",
            "fax_number": "520-836-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 W HIGHWAY 287",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "85132",
            "telephone_number": "520-868-5811",
            "fax_number": "520-868-1223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "865 N Arizola Rd",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851226011",
            "country_code": "US",
            "telephone_number": "520-836-3446",
            "fax_number": "520-836-8807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKER",
        "first_name": "SUSAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "233405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00439",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Olney, RBT
• Garrick Andrew Olsen, PA-C
• Charity Felicia Olson, PHARMD
• Kennedy Otieno Oyalo
• Blain Alan Packard
• Sophia Grace Paffumi
• Amy Nicole Peacock, FNP-C
• Ke'Alohilani M Pedro
• Phuongthao Pham
• Picacho Emergency Physicians LLC

• Family Nurse Practitioner in Florence, AZ
• Providers in Florence, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.