Provider Demographics
NPI:1316211576
Name:SPILLNER, SUZANNE ELIZABETH (MSN, FNP, RN)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:SPILLNER
Suffix:
Gender:F
Credentials:MSN, FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MARINA RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-6429
Mailing Address - Country:US
Mailing Address - Phone:707-704-8938
Mailing Address - Fax:
Practice Address - Street 1:33 MARINA RIDGE CT
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-6429
Practice Address - Country:US
Practice Address - Phone:707-704-8938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily