Grace, Susan K
Grace, Susan K is an individual health care provider with primary practice located at 400 Teegarden St Suite B, La Porte IN 46350-3175. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Grace, Susan K can be contacted via phone (219) 326-0043.Contact Information
Primary practice address
400 Teegarden St Suite B
La Porte IN 46350-3175
Phone: (219) 326-0043
Fax: (219) 326-8909
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 71000443 | Indiana |
Profile Details
| NPI number | 1891838629 |
|---|---|
| LBN Legal business name | Grace, Susan K |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2007 |
| Last updated | Dec 23rd, 2014 - about 10 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 | 1891838629 | NPPES |
| Indiana | MEDICAID | 200812400 |
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