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General NPI Number Information
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NPI Number | 1497920029
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Entity Type | Individual
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Provider Name | SUSAN P LINEBERRY NP
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Gender | Female
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 09/09/2014
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Provider Practice Location Address
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Address Line | 510 N ELAM AVE SUITE 101
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City | GREENSBORO
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State | NC
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Zip | 27403-1150
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Country | US
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Telephone | 336-854-8800
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Fax | 336-299-4308
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Provider Business Mailing Address
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Address Line | 510 N ELAM AVE SUITE 101
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City | GREENSBORO
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State | NC
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Zip | 27403-1150
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Country | US
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Telephone | 336-854-8800
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Fax | 336-299-4308
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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 | 800017
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License Number State | NC
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