Individual
SUZANNE M HOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
745 RUSSELL ST., CRAIG, CO 81625-2019
(970) 824-8233
(970) 824-2548
Mailing address
745 RUSSELL ST., CRAIG, CO 81625-2019
(970) 824-8233
(970) 824-2548
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
ARNP2028832
FL
363LF0000X
Family Nurse Practitioner
Primary
990241
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302248000
—
FL
01
—
Y7040
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/08/2006
Last updated
12/07/2011
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