Individual
SUSAN P CHASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN/CNM
Contact information
Practice address
475 WEST 940 NORTH, PROVO, UT 84604
(801) 357-7930
(801) 357-7014
Mailing address
475 WEST 940 NORTH, PROVO, UT 84604
(801) 357-7930
(801) 357-7014
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
219067-4402
UT
363LF0000X
Family Nurse Practitioner
219067-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
942854058788-D5889
—
UT
Enumeration date
10/28/2006
Last updated
12/20/2010
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