Susan Walls-Bortman, N.P.
Nurse Practitioner, Obstetrics & Gynecology in Sierra Vista, AZ. Individual provider (NPI-1).
NPI number1679514830
StatusActive
Last updated in NPPESApr 18, 2018
Details
- NPI
- 1679514830
- Entity type
- Individual (NPI-1)
- Name
- Susan Walls-Bortman
- Credential
- N.P.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2006
- Last updated
- Apr 18, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LX0001X | Nurse Practitioner, Obstetrics & Gynecology | AP1736 | AZ | Yes |
| 163W00000X | Registered Nurse | 043027 | AZ |
Practice location
174 S Coronado Dr Ste ASierra Vista, AZ 85635-6356
Phone 520-545-0676 · Fax 520-547-2993
Mailing address
2424 N. Wyatt DriveSecond Floor
Tucson, AZ 85712
Phone 520-545-0608 · Fax 520-795-0354
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