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Individual

SUSAN INMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
550 S HUDSON AVE, AURORA, MO 65605-2362
(417) 678-5176
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2009002852
MO
363LF0000X
Family Nurse Practitioner
Primary
2016022461
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
MO
Enumeration date
06/28/2016
Last updated
08/02/2016
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