Susan Clayton
Individual provider Active NPI Registered Nurse · Canyon, TX
NPI 1962775650 · NPPES record last updated Feb 11, 2012
Key facts
- NPI
- 1962775650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 600677 (TX)
- Practice address
- 2407 8TH Ave
Canyon, TX 79015-4745 - Phone
- (806) 655-0670
- NPI assigned
- Feb 11, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 600677 | TX | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 600677 | TX | Yes |
Addresses
Primary practice location
2407 8TH Ave
Canyon, TX 79015-4745
Mailing address
2407 8TH Ave
Canyon, TX 79015-4745
Other providers in Canyon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2012. 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.