Ellsberry, Susan
Ellsberry, Susan is an individual health care provider with primary practice located at 2610 E Baltimore St , Baltimore MD 21224-1129. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Ellsberry, Susan can be contacted via phone (410) 821-7644.Contact Information
Primary practice address
2610 E Baltimore St
Baltimore MD 21224-1129
Phone: (410) 821-7644
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | R093801 | Maryland |
Profile Details
| NPI number | 1710984356 |
|---|---|
| LBN Legal business name | Ellsberry, Susan |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2005 |
| Last updated | Jun 6th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710984356 | NPPES |
| Maryland | MEDICAID | 984560700 | |
| Maryland | Other | 454MG840 |
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