Provider Demographics
NPI:1366730483
Name:PETERS, SUZANNE (NP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:PETERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:629 S PLUMMER AVE
Mailing Address - Street 2:PO BOX 426
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-1928
Mailing Address - Country:US
Mailing Address - Phone:620-431-4000
Mailing Address - Fax:620-431-7556
Practice Address - Street 1:13920 HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:KS
Practice Address - Zip Code:66733-5001
Practice Address - Country:US
Practice Address - Phone:620-244-5105
Practice Address - Fax:620-244-5111
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-055412-061163W00000X
KS75493363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse