Provider Demographics
NPI:1306526165
Name:BEST, SUSANNAH LAREE (RN)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:LAREE
Last Name:BEST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUSANNAH
Other - Middle Name:LAREE
Other - Last Name:MEEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:20258 US HIGHWAY 18 STE 430-113
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-6197
Mailing Address - Country:US
Mailing Address - Phone:760-810-6399
Mailing Address - Fax:
Practice Address - Street 1:12370 HESPERIA RD STE 13
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5808
Practice Address - Country:US
Practice Address - Phone:760-245-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA727862163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management