Provider Demographics
NPI:1902957616
Name:NORDHUES, SUSAN JEANNE (RN,MSN,ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JEANNE
Last Name:NORDHUES
Suffix:
Gender:F
Credentials:RN,MSN,ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 NW 62ND TER
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2408
Mailing Address - Country:US
Mailing Address - Phone:816-584-8884
Mailing Address - Fax:
Practice Address - Street 1:1530 N CHURCH RD
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-7129
Practice Address - Country:US
Practice Address - Phone:816-781-1696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-45989-012363LA2200X
MO140573363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161860OtherBCBS KS OUTREACH CLINICS
KS200536020AMedicaid
MO1902957616OtherCOMMUNITY HEALTH PLAN
KS200536020BMedicaid
KS200536020AMedicaid
MO1902957616OtherCOMMUNITY HEALTH PLAN
KSP00696084Medicare PIN
KS161860Medicare PIN
MO038E00014Medicare PIN
MO038F181AMedicare PIN
KS161860OtherBCBS KS OUTREACH CLINICS
KS038B0015Medicare PIN