Provider Demographics
NPI:1720510845
Name:PIERSON, SUZANNE M (CRT)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:M
Last Name:PIERSON
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 HIDDEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IA
Mailing Address - Zip Code:52327-9007
Mailing Address - Country:US
Mailing Address - Phone:319-338-0582
Mailing Address - Fax:
Practice Address - Street 1:3036 HIDDEN MEADOW DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IA
Practice Address - Zip Code:52327-9007
Practice Address - Country:US
Practice Address - Phone:319-338-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02082227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified