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NPI Code Detail

MEDICARE: MRS. SUSAN JOANN GARRETT RN, BSN

MEDICARE: MRS. SUSAN JOANN GARRETT RN, BSN
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
12084P0800XPsychiatry PhysicianRN274327-LPA

General Provider Information

NPI Number : 1962336156
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN JOANN GARRETT RN, BSN
Provider Business Mailing Address
First Line : 750 E BROAD ST
Second Line :
City : HAZLETON
State : PA
Zip : 18201-6835
Country : US
Telephone Number : 570-455-6385
Fax Number : 570-579-0355
Provider Business Practice Location Address
First Line : 750 E BROAD ST
Second Line :
City : HAZLETON
State : PA
Zip : 18201-6835
Country : US
Telephone Number : 570-455-6385
Fax Number : 570-579-0355
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

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