=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760443865
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSAN COONAHAN HITE CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2006
-----------------------------------------------------
Last Update Date | 01/09/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1697 CROWN AVE SUITE 100
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17601-6310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-299-5000
-----------------------------------------------------
Fax | 717-431-4310
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 409 S 2ND ST STE 2F
-----------------------------------------------------
City | HARRISBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17104-1612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-231-8937
-----------------------------------------------------
Fax | 717-231-8588
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | SP008005
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------