Individual
ABBIE JO SUSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
801 5TH ST, SIOUX CITY, IA 51101-1326
(712) 301-2678
Mailing address
1491 KNOX AVE, KINGSLEY, IA 51028-8010
(712) 301-2678
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
134279
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
129696
IA
Other
Enumeration date
04/22/2020
Last updated
07/13/2024
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