Ettinger, Susan W

Ettinger, Susan W is an individual health care provider with primary practice located at 2360 W Joppa Rd , Lutherville Timonium MD 21093-4624. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Ettinger, Susan W can be contacted via phone (410) 847-3535.

Contact Information

Primary practice address
2360 W Joppa Rd Lutherville Timonium MD 21093-4624
Phone: (410) 847-3535
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 279604 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R078653 Maryland

Profile Details

NPI number 1144325275
LBN Legal business name Ettinger, Susan W
Credentials MSN,NPC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Feb 5th, 2024 - about 9 months 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 1144325275 NPPES
Massachusetts MEDICAID 0718126

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