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General NPI Number Information
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NPI Number | 1780545921
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Entity Type | Individual
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Provider Name | SUSANNE URICH RN
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Gender | Female
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 188 HOSPITAL LN
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City | JELLICO
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State | TN
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Zip | 37762-4400
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Country | US
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Telephone | 423-455-0245
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Fax |
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Provider Business Mailing Address
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Address Line | 3504 HIGHWAY 153 UNIT 242
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City | GREENVILLE
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State | SC
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Zip | 29611-7553
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Country | US
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Telephone | 864-905-2644
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 62709
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License Number State | SC
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