Carbajal, Susan M.

Carbajal, Susan M. is an individual health care provider with primary practice located at 2809 Denny Ave , Pascagoula MS 39581-5301. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Carbajal, Susan M. can be contacted via phone (228) 809-5419.

Contact Information

Primary practice address
2809 Denny Ave Pascagoula MS 39581-5301
Phone: (228) 809-5419
Fax: (228) 809-5076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 904490 Mississippi

Profile Details

NPI number 1376138859
LBN Legal business name Carbajal, Susan M.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2021
Last updated May 2nd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376138859 NPPES
Mississippi MEDICAID 00072750

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