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MRS. MARIE MAUDE SUSSMAN NP

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1043470966

Individual Registrant:
MRS. MARIE MAUDE SUSSMAN NP
Gender: F
Sole Proprietor

Location and contact information for practice:
1205 N HWY 11  WEST UNION, SC 29696 US
Tel: 864-638-5402  Fax: 864-638-6126

Contact information for business:
282 JOCASSEE RIDGE WAY  SALEM, SC 29676 US
Tel: 914-391-8853  Fax: --

Registration Information:
NPI: 1043470966
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
SC18034
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
NYF420414-1

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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