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Individual

SUSAN PAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
700 E UNIVERSITY AVE, DES MOINES, IA 50316-2302
(515) 263-5612
Mailing address
925 SHERWOOD DR, LAKE BLUFF, IL 60044-2203

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
089666
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0400122
IA
05
2400122
IA
01
58124
WELLMARK
IA
Enumeration date
02/19/2007
Last updated
10/17/2007
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