Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0131X | Foot Surgery | 016-003857 | IL |
Y | 213ES0131X | Foot Surgery | 0299 | AZ |
N | 213ES0131X | Foot Surgery | 1431 | TX |
NPI | 1174597397 |
---|---|
Provider Name | Dr. Susan Elizabeth Erredge |
First Address | Zuni, NM 87327-0467 |
Second Address | Zuni, NM 87327-0467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 24/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1295578-06 | (05) | TX |
54555361 | (05) | NM |
HSZ919YPHU | (02) | NM |
T38927 | (02) | AZ |