Individual
SUSAN J MAXCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, CDE
Contact information
Practice address
3911 AVENUE B STE 1110, SCOTTSBLUFF, NE 69361-4617
(308) 220-4303
(308) 630-2139
Mailing address
3911 AVENUE B STE 1110, SCOTTSBLUFF, NE 69361-4617
(308) 220-4303
(308) 630-2139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
25917
NE
163WD0400X
Diabetes Educator Registered Nurse
2061-0243
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025668100
—
NE
Enumeration date
06/30/2009
Last updated
06/30/2009
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