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General NPI Number Information
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NPI Number | 1760894901
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Entity Type | Individual
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Provider Name | SUSAN ORSBON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/22/2014
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 3499 HIGHWAY 70 W
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City | DICKSON
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State | TN
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Zip | 37055-4234
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Country | US
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Telephone | 615-326-8121
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Fax |
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Provider Business Mailing Address
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Address Line | 10256 MCGEE RD
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City | LYLES
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State | TN
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Zip | 37098-1738
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Country | US
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Telephone | 615-512-4099
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 145253
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19587
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License Number State | TN
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