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General NPI Number Information
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NPI Number | 1457638074
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Entity Type | Individual
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Provider Name | SUSAN BARB CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 1401 CHESTER PIKE SUITE B
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City | EDDYSTONE
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State | PA
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Zip | 19022-1336
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Country | US
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Telephone | 610-447-0609
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Fax | 610-649-4421
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Provider Business Mailing Address
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Address Line | 1401 CHESTER PIKE SUITE B
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City | EDDYSTONE
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State | PA
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Zip | 19022-1336
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Country | US
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Telephone | 610-447-0609
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Fax | 610-649-4421
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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 | SP011731
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License Number State | PA
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