=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255323556
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUZANNE RANSEHOUSEN CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2005
-----------------------------------------------------
Last Update Date | 09/02/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 726 LOVEVILLE RD
-----------------------------------------------------
City | HOCKESSIN
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19707-1515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-235-6026
-----------------------------------------------------
Fax | 302-239-0989
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8 NEWFIELD CT
-----------------------------------------------------
City | WEST GROVE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19390-8942
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-869-5689
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | RXAPN3338
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------