Provider Demographics
NPI:1386317261
Name:HEWTTY, SUZANNA (FNP-BC)
Entity type:Individual
Prefix:
First Name:SUZANNA
Middle Name:
Last Name:HEWTTY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 W FM 700
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-6556
Mailing Address - Country:US
Mailing Address - Phone:432-517-4837
Mailing Address - Fax:
Practice Address - Street 1:706 W FM 700
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-6556
Practice Address - Country:US
Practice Address - Phone:432-517-4837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX818286163W00000X
TX1049978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse