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General NPI Number Information
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NPI Number | 1922029867
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Entity Type | Individual
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Provider Name | SUSAN ANN BISSETTE ANP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 109 BEE ST
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City | CHARLESTON
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State | SC
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Zip | 29401-5703
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Country | US
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Telephone | 843-789-6515
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Fax | 843-805-5790
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Provider Business Mailing Address
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Address Line | 22 SHORT ST
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City | CHARLESTON
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State | SC
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Zip | 29401-1908
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Country | US
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Telephone | 843-723-2970
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Fax | 843-805-5790
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APN43
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License Number State | SC
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