Individual
SUSAN GAYLE POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
550 POPE AVE, MUNSON ARMY HEALTH CENTER ATTN MCXN-COD, MS COTTON, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6562
(913) 684-6208
Mailing address
412 BROOKWOOD ST, LANSING, KS 66043-1488
(913) 727-5283
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
14-97418-081
KS
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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