Healthcare Provider Details

I. General information

NPI: 1114877909
Provider Name (Legal Business Name): SUZETTE VERBECK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 WISCONSIN AVE NW APT 446
WASHINGTON DC
20015-2046
US

IV. Provider business mailing address

5300 WISCONSIN AVE NW APT 446
WASHINGTON DC
20015-2046
US

V. Phone/Fax

Practice location:
  • Phone: 706-814-0533
  • Fax:
Mailing address:
  • Phone: 706-814-0533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN500341682
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: