Roberts, Susan Diane
Roberts, Susan Diane is an sole proprietor health care provider with primary practice located at 131 Jpm Rd Ste A , Lewisburg PA 17837-9309. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Roberts, Susan Diane can be contacted via phone (570) 523-6115.Contact Information
Primary practice address
131 Jpm Rd Ste A
Lewisburg PA 17837-9309
Phone: (570) 523-6115
Fax: (570) 523-6178
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | OA000816 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | MA051057 | Pennsylvania |
Profile Details
| NPI number | 1114966686 |
|---|---|
| LBN Legal business name | Roberts, Susan Diane |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Oct 5th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114966686 | NPPES |
| Pennsylvania | Other | 1031658940001 | MEDICAID |
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