Van Fossen, Susan J

Van Fossen, Susan J is an sole proprietor health care provider with primary practice located at 616 W Russell Pl , San Antonio TX 78212-3658. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Van Fossen, Susan J can be contacted via phone (800) 257-8715.

Contact Information

Primary practice address
616 W Russell Pl San Antonio TX 78212-3658
Phone: (800) 257-8715
Fax: (800) 819-1655
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 232874 Texas

Profile Details

NPI number 1558309328
LBN Legal business name Van Fossen, Susan J
Credentials RN, MSN, BC, PMHNP,
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 3rd, 2006
Last updated Feb 19th, 2010 - about 14 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 1558309328 NPPES
Texas Other 87N290 BLUE CROSS BLUE SHIELD
Texas MEDICAID 118282603 BLUE CROSS BLUE SHIELD
Texas Other 118282605 BLUE CROSS BLUE SHIELD
Texas MEDICAID 118282601 BLUE CROSS BLUE SHIELD
Texas Other 500012787 BLUE CROSS BLUE SHIELD
Texas MEDICAID 118282602 BLUE CROSS BLUE SHIELD
Texas Other 8N3327 BLUE CROSS BLUE SHIELD

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