Waterbury, Susan Ruth

Waterbury, Susan Ruth is an individual health care provider with primary practice located at 1495 N Harbor City Blvd , Melbourne FL 32935-6572. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Waterbury, Susan Ruth can be contacted via phone (321) 253-0846.

Contact Information

Primary practice address
1495 N Harbor City Blvd Melbourne FL 32935-6572
Phone: (321) 253-0846
Fax: (321) 253-1004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 314100168 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0001251055 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN2116242 Florida

Profile Details

NPI number 1508824699
LBN Legal business name Waterbury, Susan Ruth
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jan 31st, 2024 - about last year

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 1508824699 NPPES
Florida MEDICAID 303783500

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