Individual
SUSAN A WALZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1221 S GEAR AVE, WEST BURLINGTON, IA 52655-1679
(319) 768-1000
(319) 768-3460
Mailing address
PO BOX 540, WEST BURLINGTON, IA 52655-0540
(319) 768-1000
(319) 768-3460
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
119390
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119390
LICENSE
IA
05
—
1851554703
—
IA
01
—
P00623409
RAILROAD MEDICARE
IA
Enumeration date
07/09/2008
Last updated
01/22/2009
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