MS. SUZANN L POLK (NPI# 1164523098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164523098 |
| Entity Type | Individual |
| Full Name | MS. SUZANN L POLK |
| Credential | APRN-BC |
| Practice Address |
2940 Somerset Dr Prescott AZ 86305-5006 |
| Practice Telephone | 9285419024 |
| Mailing Telephone | 9285419024 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2016-03-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN044136/APO199 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
RN044136/APO199 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2940 SOMERSET DR |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305-5006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184630865 | Karen A. Burton | Nurse Practitioner | 1400 N Acres Rd Ste 30, Prescott, WI 54021-7039 | 2006-08-01 |
| 1538725916 | Utibe Joshua Etudor | Nurse Practitioner | 810 Ainsworth Dr Ste A, Prescott, AZ 86301-1612 | 2019-05-11 |
| 1144697301 | Carol G Underwood | Nurse Practitioner | 1484 W 1st St N, Prescott, AR 71857-3339 | 2015-08-24 |
| 1144329905 | Mary Ann Bell | Nurse Practitioner | 500 Highway 89, Northnorthern Arizona Va Health Care System, Prescott, AZ 86313 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425123 | Erin Jean Mcmanus-tomanek | Nurse Practitioner | 12851 N 142nd Ave, Surprise, AZ 85379-9502 | 2020-10-21 |
| 1154928463 | Willie Sellers | Nurse Practitioner | 15354 W Charter Oak Rd, Surprise, AZ 85379-9184 | 2020-10-08 |
| 1760090427 | Debra Shannon Witthar | Nurse Practitioner | 10515 W Santa Fe Dr Bldg B, Sun City, AZ 85351-3020 | 2020-07-20 |
| 1255955506 | Christy J Holloway | Nurse Practitioner | 2645 E Southern Ave, Tempe, AZ 85282-7649 | 2020-06-02 |
| 1013552124 | Alliance With The Covenant of The Trinity Arizona Inc | Nurse Practitioner | 2 N Central Ave Fl 18, Phoenix, AZ 85004-2322 | 2019-11-12 |
| 1184197691 | Waheed Olawoyin Olabode | Nurse Practitioner | 12853 S 184th Ave, Goodyear, AZ 85338-2642 | 2019-01-08 |
| 1508381880 | Marcie Marie Camblin | Nurse Practitioner | 16551 N Naegel Dr, Surprise, AZ 85374-5411 | 2017-08-08 |
| 1508105727 | Geriatric Health Services, Plc | Nurse Practitioner | 1013 W Longhorn Rd, Payson, AZ 85541-4282 | 2013-02-07 |
| 1194070227 | Debra Rouse Haber | Nurse Practitioner | 755 S Grapevine Loop, Benson, AZ 85602-7430 | 2012-07-15 |
| 1346504818 | Your Nurse Practitioner LLC | Nurse Practitioner | 6261 Boothwyn St, Prescott Valley, AZ 86314-6726 | 2012-06-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.