Most Relevant Information
Provider Data
| NPI Number: | 1003002601 |
| Provider Name: | SUSAN P NURSE LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 199450-1 |
Most Important Dates
| Enumeration Date: | 09/18/2007 |
| Last Updated: | 09/18/2007 |
Provider Practice Location
13319 CHAPMAN CORNERS RD
RED CREEK
NY
131433187
Practice Location Phone/Fax
| Phone: | 3158791099 |
| Fax: |
Provider Mailing Location
13319 CHAPMAN CORNERS RD
RED CREEK
NY
131433187
Provider Mailing Phone/Fax
| Phone: | 3158791099 |
| Fax: |