Individual
MRS. SUSAN D COONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4049 S CAMPBELL AVE, SPRINGFIELD, MO 65807-5303
(417) 890-5550
(417) 889-6898
Mailing address
4049 S CAMPBELL AVE, SPRINGFIELD, MO 65807-5303
(417) 890-5550
(417) 889-6898
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
83192
MO
363L00000X
Nurse Practitioner
Primary
APRN11007578
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425256617
—
MO
Enumeration date
02/06/2006
Last updated
09/15/2021
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