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General NPI Number Information
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NPI Number | 1093927212
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Entity Type | Individual
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Provider Name | SUSAN L SEARS
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 1001 ACE DR
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City | BEREA
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State | KY
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Zip | 40403-1327
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Country | US
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Telephone | 859-228-2048
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Fax |
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Provider Business Mailing Address
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Address Line | 214 BOGGS LN
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City | RICHMOND
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State | KY
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Zip | 40475-2522
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Country | US
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Telephone | 859-228-2048
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2603P
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1071441
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License Number State | KY
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