Provider Demographics
NPI:1891791737
Name:RODMAN, SUZANNE D (RN)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:D
Last Name:RODMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OPHIR DR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8800
Mailing Address - Country:US
Mailing Address - Phone:970-385-7899
Mailing Address - Fax:
Practice Address - Street 1:16 OPHIR DR
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8800
Practice Address - Country:US
Practice Address - Phone:970-385-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-143218163WP0200X
CO198025163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0200XNursing Service ProvidersRegistered NursePediatrics