SUSAN P NURSE LPN NPI 1003002601

Licensed Practical Nurse in Red Creek, NY

About SUSAN NURSE

Susan Nurse is a provider in Red Creek, NY. The NPI number assigned to this provider is 1003002601. The practitioner's primary taxonomy code is Licensed Practical Nurse (164W00000X). The provider is registered as an individual and their NPI record was last updated 10 years ago.

NPI1003002601 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name SUSAN P NURSE LPN
Provider Location Address13319 CHAPMAN CORNERS RD RED CREEK, NY 13143 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address13319 CHAPMAN CORNERS RD RED CREEK, NY 13143 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date09-18-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-18-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

SUSAN P NURSE LPN
13319 CHAPMAN CORNERS RD
RED CREEK, NY
ZIP 13143
Phone: (315) 879-1099
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Mailing Address

SUSAN P NURSE LPN
13319 CHAPMAN CORNERS RD
RED CREEK, NY
ZIP 13143
Phone: (315) 879-1099

Primary Taxonomy

Taxonomy Code164W00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationLicensed Practical Nurse
TypeNursing Service Providers
License No.199450-1
License StateNY
Taxonomy DescriptionAn individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
02824073MEDICAID (05)NY

Map Location


SUSAN P NURSE LPN address is 13319 CHAPMAN CORNERS RD RED CREEK, NY 13143