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General NPI Number Information
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NPI Number | 1033165253
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Entity Type | Individual
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Provider Name | SUSAN E DESROCHES FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1501 TATE BLVD SE SUITE 201
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City | HICKORY
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State | NC
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Zip | 28602-4243
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Country | US
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Telephone | 828-322-4140
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Fax | 828-322-3767
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Provider Business Mailing Address
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Address Line | PO BOX 38
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City | HICKORY
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State | NC
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Zip | 28603-0038
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Country | US
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Telephone | 828-322-4140
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Fax | 828-322-3767
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201038
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License Number State | NC
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