Healthcare Provider Details

I. General information

NPI: 1518921386
Provider Name (Legal Business Name): SUZANNE K. BARGER MSN/RN/ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE K. WOODRUFF

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 MADISON AVE
COVINGTON KY
41011-1562
US

IV. Provider business mailing address

502 FARRELL DR
COVINGTON KY
41011-3717
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-3292
  • Fax: 859-578-2864
Mailing address:
  • Phone: 859-331-3292
  • Fax: 859-578-2864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number3002318
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: