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General NPI Number Information
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NPI Number | 1518823913
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Entity Type | Individual
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Provider Name | SUSAN WIRT RN
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 5262 KEFFER RD
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City | CATAWBA
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State | VA
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Zip | 24070-2122
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Country | US
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Telephone | 540-529-3631
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Fax | 540-404-3271
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Provider Business Mailing Address
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Address Line | 5262 KEFFER RD
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City | CATAWBA
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State | VA
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Zip | 24070-2122
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Country | US
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Telephone | 540-529-3631
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Fax | 540-404-3271
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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 | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | 0001066308
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License Number State | VA
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