Walls-Bortman, Susan

Walls-Bortman, Susan is an individual health care provider with primary practice located at 174 S Coronado Dr Ste A , Sierra Vista AZ 85635-6356. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology. Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology is her primary health care specialty. Walls-Bortman, Susan can be contacted via phone (520) 545-0676.

Contact Information

Primary practice address
174 S Coronado Dr Ste A Sierra Vista AZ 85635-6356
Phone: (520) 545-0676
Fax: (520) 547-2993
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 043027 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology 363LX0001X AP1736 Arizona

Profile Details

NPI number 1679514830
LBN Legal business name Walls-Bortman, Susan
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Apr 18th, 2018 - about 6 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 1679514830 NPPES
Arizona MEDICAID 817223

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