Individual
SUSAN KNOWLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 EL CAMINO REAL, SIERRA VISTA, AZ 85635
(520) 458-1696
Mailing address
1900 S GNOME TRL, SIERRA VISTA, AZ 85635-5665
(520) 249-1415
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN085905
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1Z3704
HEALTH NET
—
05
—
320002
—
AZ
Enumeration date
06/06/2006
Last updated
07/07/2010
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