Mallatt, Suzanne T

Mallatt, Suzanne T is an individual health care provider with primary practice located at 7600 S Highway 69A , Miami OK 74354-1016. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Mallatt, Suzanne T can be contacted via phone (918) 542-1655.

Contact Information

Primary practice address
7600 S Highway 69A Miami OK 74354-1016
Phone: (918) 542-1655
Fax: (918) 540-1685
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 147011 Missouri

Profile Details

NPI number 1417984352
LBN Legal business name Mallatt, Suzanne T
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Dec 19th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417984352 NPPES
Missouri MEDICAID 425773108

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