Provider Demographics
NPI:1730586322
Name:DRAGOO, SUSAN ANN (APRN WHNP/FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ANN
Last Name:DRAGOO
Suffix:
Gender:F
Credentials:APRN WHNP/FNP-BC
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:ANN
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 W. STEWART DR.
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-5600
Mailing Address - Country:US
Mailing Address - Phone:714-771-8000
Mailing Address - Fax:714-744-8571
Practice Address - Street 1:1100 W. STEWART DR.
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-5600
Practice Address - Country:US
Practice Address - Phone:714-771-8000
Practice Address - Fax:714-744-8571
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN305899163W00000X
CA9519363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily