Provider Demographics
NPI:1053756759
Name:LEON, SUSAN BECKER (RN, GNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BECKER
Last Name:LEON
Suffix:
Gender:F
Credentials:RN, GNP-BC
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Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6084
Mailing Address - Country:US
Mailing Address - Phone:636-947-2334
Mailing Address - Fax:
Practice Address - Street 1:1820 ZUMBEHL RD STE 120
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-2761
Practice Address - Country:US
Practice Address - Phone:636-947-2334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO105654363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology