Healthcare Provider Details

I. General information

NPI: 1972742047
Provider Name (Legal Business Name): SUSAN ELIZABETH PLAYER APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN ELIZBETH PLAYER APRN-BC

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 PARKWAY NORTH BLVD STE C
CUMMING GA
30040-1430
US

IV. Provider business mailing address

5965 PARKWAY NORTH BLVD STE C
CUMMING GA
30040-1430
US

V. Phone/Fax

Practice location:
  • Phone: 770-475-8014
  • Fax: 770-886-0404
Mailing address:
  • Phone: 770-475-8014
  • Fax: 770-886-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN190060
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: