Healthcare Provider Details

I. General information

NPI: 1255249801
Provider Name (Legal Business Name): SUZANNE VAN KIRK PHD, MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 KINCADE DR
MOUNT PLEASANT SC
29464-4517
US

IV. Provider business mailing address

937 KINCADE DR
MOUNT PLEASANT SC
29464-4517
US

V. Phone/Fax

Practice location:
  • Phone: 814-441-0021
  • Fax:
Mailing address:
  • Phone: 814-441-0021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008248
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23837
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: