Individual
MRS. SUSAN KATHERINE FRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
715 S 9TH ST, CANON CITY, CO 81212-4911
(719) 269-8820
(719) 204-0230
Mailing address
1203 ELM AVE, CANON CITY, CO 81212-4829
(303) 981-6221
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10059
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60539577
—
CO
Enumeration date
06/14/2010
Last updated
03/29/2016
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