Individual
SUSAN M. MIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
760 GOLF VIEW DRIVE, SUITE #200, MEDFORD, OR 97504
(541) 618-4400
(541) 618-4406
Mailing address
760 GOLF VIEW DRIVE, SUITE #200, MEDFORD, OR 97504
(541) 618-4400
(541) 618-4406
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200750116NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227698
—
OR
Enumeration date
09/06/2007
Last updated
09/26/2013
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