Healthcare Provider Details

I. General information

NPI: 1144269762
Provider Name (Legal Business Name): SUZANNE FINLEY ULMER PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 BATESVILLE RD
SIMPSONVILLE SC
29681-4816
US

IV. Provider business mailing address

525 VERDAE BLVD STE 200
GREENVILLE SC
29607-4021
US

V. Phone/Fax

Practice location:
  • Phone: 864-272-0388
  • Fax: 864-213-9237
Mailing address:
  • Phone: 864-272-0388
  • Fax: 864-213-9237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5008995
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2229
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: