Provider Demographics
NPI:1386750511
Name:MORSE, SUZANNE LEA (APRN)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:LEA
Last Name:MORSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1210 MARISSA CIR
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-3123
Mailing Address - Country:US
Mailing Address - Phone:928-474-2234
Mailing Address - Fax:928-474-4056
Practice Address - Street 1:203 S CANDY LN
Practice Address - Street 2:SUITE 2A
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4120
Practice Address - Country:US
Practice Address - Phone:928-300-8754
Practice Address - Fax:928-474-4056
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ22-E875Medicare UPIN