Mix, Susan M.
Mix, Susan M. is an individual health care provider with primary practice located at 760 Golf View Drive Suite #200, Medford OR 97504. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mix, Susan M. can be contacted via phone (541) 618-4400.Contact Information
Primary practice address
760 Golf View Drive Suite #200
Medford OR 97504
Phone: (541) 618-4400
Fax: (541) 618-4406
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 200750116NP | Oregon |
Profile Details
| NPI number | 1467647115 |
|---|---|
| LBN Legal business name | Mix, Susan M. |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2007 |
| Last updated | Sep 26th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467647115 | NPPES |
| Oregon | MEDICAID | 227698 |
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