Individual provider · Type 1 NPI
Susan Chacko, APRN
Primary Care Nurse Practitioner · Dallas, TX
NPI number
1710573159
Active
Practice location
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Mailing address
1024 Blue Heron Dr
Forney, TX 75126-8311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | AP140734 (TX) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1710573159
Susan Chacko, APRN's National Provider Identifier is 1710573159, issued on Dec 20, 2020. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Dallas, TX. The record was last updated on Dec 20, 2020.