Healthcare Provider Details

I. General information

NPI: 1306357066
Provider Name (Legal Business Name): SUSAN EVONNE MCNATT CONLEY APRN, ACNS-BC, RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2017
Last Update Date: 10/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST
DOVER DE
19901-3530
US

IV. Provider business mailing address

4526 KENTON RD
DOVER DE
19904-0911
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-6579
  • Fax: 302-744-6579
Mailing address:
  • Phone: 302-222-3868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0026123
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberL9-0000116
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: