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:
Health care specialties
| Specialty | Code | License # | 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 15 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 | 1114075405 | NPPES |
| Arkansas | MEDICAID | 130689721 | |
| Arkansas | Other | 5X798 |
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