Peterson, Susan Grizzard

Peterson, Susan Grizzard is an individual health care provider with primary practice located at 225 E Wood St , Spartanburg SC 29303-3050. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Peterson, Susan Grizzard can be contacted via phone (864) 560-4420.

Contact Information

Primary practice address
225 E Wood St Spartanburg SC 29303-3050
Phone: (864) 560-4420
Fax: (864) 560-5296
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4281 South Carolina

Profile Details

NPI number 1124330014
LBN Legal business name Peterson, Susan Grizzard
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2010
Last updated Dec 2nd, 2020 - about 4 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 1124330014 NPPES
South Carolina Other AA57905019 MEDICARE PIN
South Carolina MEDICAID NP1650 MEDICARE PIN
South Carolina MEDICAID 7004655 MEDICARE PIN
South Carolina Other P01322006 MEDICARE PIN

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