Provider Demographics
NPI:1336191337
Name:SANDERS, SUSANNE E (RXN, NP)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:E
Last Name:SANDERS
Suffix:
Gender:F
Credentials:RXN, NP
Other - Prefix:
Other - First Name:SUSANNE
Other - Middle Name:E
Other - Last Name:LOVKVIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RXN, NP
Mailing Address - Street 1:1017 ROBERTSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3926
Mailing Address - Country:US
Mailing Address - Phone:970-472-5000
Mailing Address - Fax:970-490-6161
Practice Address - Street 1:1017 ROBERTSON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3926
Practice Address - Country:US
Practice Address - Phone:970-472-5000
Practice Address - Fax:970-490-6161
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO66980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily