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Individual

MS. SUZANN L POLK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN-BC

Contact information

Practice address
2940 SOMERSET DR, PRESCOTT, AZ 86305-5006
(928) 541-9024
Mailing address
2940 SOMERSET DR, PRESCOTT, AZ 86305-5006
(928) 541-9024

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN044136/APO199
AZ
363LG0600X
Gerontology Nurse Practitioner
Primary
RN044136/APO199
AZ

Other

Enumeration date
09/25/2006
Last updated
03/30/2016
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