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NPI Code Detail

MEDICARE: MRS. SUSAN ARLENE SPRAKER PHN

MEDICARE:  MRS. SUSAN ARLENE SPRAKER  PHN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse22-417363NY

General Provider Information

NPI Number : 1518102383
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN ARLENE SPRAKER PHN
Provider Business Mailing Address
First Line : 29 PINE AVE
Second Line :
City : JOHNSTOWN
State : NY
Zip : 12095-1112
Country : US
Telephone Number : 518-762-9520
Fax Number :
Provider Business Practice Location Address
First Line : 2714 STATE HIGHWAY 29
Second Line :
City : JOHNSTOWN
State : NY
Zip : 12095-4041
Country : US
Telephone Number : 518-736-5720
Fax Number : 518-762-1382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2008
Last Update Date : 12/09/2008

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Directions to “ MRS. SUSAN ARLENE SPRAKER PHN” Practice Location

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