Individual
MS. SUSAN JEAN BADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2850 N 24TH ST, PHOENIX, AZ 85008-1004
(602) 266-5976
(602) 274-8952
Mailing address
2850 N 24TH ST, PHOENIX, AZ 85008-1004
(602) 266-5976
(602) 274-8952
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
99392
CO
163WP0200X
Pediatric Registered Nurse
Primary
RN170031
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042127
—
AZ
05
—
936560
—
AZ
01
—
99392
LICENSE
CO
Enumeration date
03/22/2007
Last updated
11/25/2013
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