Provider Demographics
NPI:1447328596
Name:SUZANNE L. HAVEMAN, CRNFA, INC.
Entity type:Organization
Organization Name:SUZANNE L. HAVEMAN, CRNFA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAVEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:541-488-1840
Mailing Address - Street 1:245 MAYWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9511
Mailing Address - Country:US
Mailing Address - Phone:541-488-1840
Mailing Address - Fax:541-482-7642
Practice Address - Street 1:245 MAYWOOD WAY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-9511
Practice Address - Country:US
Practice Address - Phone:541-488-1840
Practice Address - Fax:541-482-7642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566627163WR0006X
OR163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty