Prendergast, Susan M

Prendergast, Susan M is an sole proprietor health care provider with primary practice located at 3533 Sw Vincennes St , Port St Lucie FL 34953-3771. 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. Prendergast, Susan M can be contacted via phone (954) 821-9337.

Contact Information

Primary practice address
3533 Sw Vincennes St Port St Lucie FL 34953-3771
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP 3201922 Florida

Profile Details

NPI number 1447587944
LBN Legal business name Prendergast, Susan M
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2009
Last updated Nov 4th, 2009 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447587944 NPPES
Florida MEDICAID 3066631 00

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