Russell, Susan P
Russell, Susan P is an individual health care provider with primary practice located at 213 Mcclanahan St Sw , Roanoke VA 24014-1721. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Russell, Susan P can be contacted via phone (540) 981-8025.Contact Information
Primary practice address
213 Mcclanahan St Sw
Roanoke VA 24014-1721
Phone: (540) 981-8025
Fax: (540) 982-3404
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 24166830 | Virginia |
Profile Details
| NPI number | 1689614356 |
|---|---|
| LBN Legal business name | Russell, Susan P |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Nov 11th, 2008 - about 16 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 | 1689614356 | NPPES |
| Virginia | MEDICAID | 010266572 |
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