Provider Demographics
NPI:1215289012
Name:RUE, SUZANNE FLY (MSN, RN, FNP-C)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:FLY
Last Name:RUE
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 E. NOPAL STREET
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801
Mailing Address - Country:US
Mailing Address - Phone:830-278-4588
Mailing Address - Fax:
Practice Address - Street 1:524 E NOPAL ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-5307
Practice Address - Country:US
Practice Address - Phone:830-278-4588
Practice Address - Fax:830-278-4895
Is Sole Proprietor?:No
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249275363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily