Healthcare Provider Details

I. General information

NPI: 1740229210
Provider Name (Legal Business Name): SUZANNE P. O'KEEFE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE PATTERSON CRNP

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 UPPER CHESAPEAKE DR SUITE 312 (CCC)
BEL AIR MD
21014-4339
US

IV. Provider business mailing address

520 UPPER CHESAPEAKE DR SUITE 312 (CCC)
BEL AIR MD
21014-4339
US

V. Phone/Fax

Practice location:
  • Phone: 443-643-2273
  • Fax: 443-643-1545
Mailing address:
  • Phone: 443-643-2273
  • Fax: 443-643-1545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR122814
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: