Individual
SUSAN ERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
HWY 264 MILE POST 388, POLACCA, AZ 86042
(928) 737-6000
Mailing address
PO BOX 4000, POLACCA, AZ 86042-4000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
11625
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
09/15/2015
Last updated
09/15/2015
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