Provider Demographics
NPI:1871963769
Name:GUZMAN, SUSANA (APRN,FNP-BC)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:APRN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211699
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-3699
Mailing Address - Country:US
Mailing Address - Phone:866-849-0692
Mailing Address - Fax:
Practice Address - Street 1:200 S WACKER DR FL 31
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-5877
Practice Address - Country:US
Practice Address - Phone:866-849-0692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029647363L00000X
COAPN.0999657-NP363L00000X
TX1051467363L00000X
FLAPRN11015303363L00000X
OH0031219363L00000X
WAAP61204189363L00000X
OR10030731363L00000X
HIAPRN-4971363L00000X
IL277001622363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner