MEDICARE: SUSAN MACPHERSON APRN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN156097	MA
2	363LF0000X	Family Nurse Practitioner	APRN1293242	FL

General Provider Information

NPI Number	:	1083221519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MACPHERSON APRN, CNP

Provider Business Mailing Address
First Line	:	2511 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7917
Country	:	US
Telephone Number	:	561-653-3399
Fax Number	:

Provider Business Practice Location Address
First Line	:	2511 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-7917
Country	:	US
Telephone Number	:	561-653-3399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	09/29/2020

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