Individual
MS. SUSAN ANN HERBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 PASEO DEL PUEBLO SUR, TAOS, NM 87571
(575) 776-8421
Mailing address
100 GOLD AVE SW, #605, ALBUQUERQUE, NM 87102-3480
(505) 205-0144
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2004-0052
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40286525
—
NM
Enumeration date
02/15/2007
Last updated
09/10/2014
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