Provider Demographics
NPI:1780796144
Name:FOLEY, SUSAN (CRNA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2333
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-2333
Mailing Address - Country:US
Mailing Address - Phone:907-232-5655
Mailing Address - Fax:907-746-9590
Practice Address - Street 1:2925 DEBARR RD
Practice Address - Street 2:ANESTHESIA DEPT.
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2983
Practice Address - Country:US
Practice Address - Phone:907-257-6718
Practice Address - Fax:907-746-9590
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AK167367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered