Provider Demographics
NPI:1063773117
Name:SUCHY, CAMILLE ELIZABETH (APRN)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:ELIZABETH
Last Name:SUCHY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CAMILLE
Other - Middle Name:ELIZABETH
Other - Last Name:WEHLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2509 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2233
Mailing Address - Country:US
Mailing Address - Phone:785-623-5095
Mailing Address - Fax:785-623-5080
Practice Address - Street 1:222 S KANSAS ST
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-3000
Practice Address - Country:US
Practice Address - Phone:785-486-3333
Practice Address - Fax:785-483-0781
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5375688071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily