Individual
LISA E SUSUNAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1600 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-5511
Mailing address
1600 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-5511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
AK29714
AK
Other
Enumeration date
10/15/2009
Last updated
05/26/2020
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