Miss Susan Marie Back, MS LP is a
Psychologist based in Jackson, Minnesota. Miss Susan Marie Back is licensed to practice in Minnesota (license number LP1191) and her current practice location is
116 County Road 34 W, Jackson, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(507) 847-5952.
NPI number for Miss Susan Marie Back is 1609952027 and her current mailing address is Po Box 245, 116 County Road 34 W, Jackson, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1609952027.
Healthcare Provider's Profile
Full Name | Miss Susan Marie Back |
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Gender | Female |
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Speciality | Psychologist |
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Location | 116 County Road 34 W, Jackson, Minnesota |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1609952027
- Provider Enumeration Date: 10/27/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Miss Susan Marie Back such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1609952027 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | LP1191 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Susan Marie Back is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Miss Susan Marie Back, MS LP Po Box 245, 116 County Road 34 W, Jackson, MN 56143 Ph: (507) 847-5952 | Miss Susan Marie Back, MS LP 116 County Road 34 W, Jackson, MN 56143 Ph: (507) 847-5952 |
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