Fullerton, Suzanne Lanay

Fullerton, Suzanne Lanay is an individual health care provider with primary practice located at 12709 Meadows Edge Lane , Little Rock AR 72211-1802. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Fullerton, Suzanne Lanay can be contacted via phone (501) 514-4938.

Contact Information

Primary practice address
12709 Meadows Edge Lane Little Rock AR 72211-1802
Phone: (501) 514-4938
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 1058 Arkansas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X 1058 Arkansas

Profile Details

NPI number 1114075405
LBN Legal business name Fullerton, Suzanne Lanay
Credentials OTRL
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Dec 17th, 2010 - about 14 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 1114075405 NPPES
Arkansas MEDICAID 130689721
Arkansas Other 5X798

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