Individual
SUSAN CAROL IMKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
1305 AIRPORT FWY, SUITE 205, BEDFORD, TX 76021-6605
(817) 267-6290
(817) 267-0950
Mailing address
1305 AIRPORT FWY, SUITE 205, BEDFORD, TX 76021-6605
(817) 267-6290
(817) 267-0950
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
229206
TX
Other
Enumeration date
05/06/2009
Last updated
12/20/2012
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