# SUSAN WALLS-BORTMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1679514830
- **Gender:** F
- **Credential:** N.P.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 043027 | AZ | — |
| 363LX0001X | Obstetrics & Gynecology Nurse Practitioner | AP1736 | AZ | Yes |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 04/18/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 817223 | — | AZ |