Provider Demographics
NPI:1720632599
Name:MESSENGER, SUSAN (FNP-BC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:MESSENGER
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 1:3838 N. CAMPBELL AVE
Mailing Address - Street 2:BLD 2, 3H187
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-7403
Mailing Address - Country:US
Mailing Address - Phone:520-694-6643
Mailing Address - Fax:520-694-7851
Practice Address - Street 1:3838 N. CAMPBELL AVE
Practice Address - Street 2:BLD 2, 3H187
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-7403
Practice Address - Country:US
Practice Address - Phone:520-694-6643
Practice Address - Fax:520-694-7851
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ233015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
.Other.