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NPI Code Detail

MEDICARE: SUSAN GATELEY A.P.N.

MEDICARE: SUSAN GATELEY A.P.N.
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
1363LP2300XPrimary Care Nurse PractitionerA01730AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1020407900OTHERARBLACK LUNG PROGRAM
25U698OTHERARBLUE CROSS BLUE SHIELD AR
30062731OTHERARUMWA H&R FUNDS
40790780001OTHERARPALMETTO GBA
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6435205OTHERARHEALTH LINK
7XX12984OTHERARHEALTH PLUS OF MICHIGAN

General Provider Information

NPI Number : 1083684740
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN GATELEY A.P.N.
Provider Business Mailing Address
First Line : PO BOX 668
Second Line :
City : CLARKSVILLE
State : AR
Zip : 72830-0668
Country : US
Telephone Number : 479-754-8384
Fax Number : 479-754-7141
Provider Business Practice Location Address
First Line : 601 W MCKENNON ST
Second Line :
City : CLARKSVILLE
State : AR
Zip : 72830-3523
Country : US
Telephone Number : 479-754-8384
Fax Number : 479-754-7141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 09/22/2011

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Directions to “ SUSAN GATELEY A.P.N.” Practice Location

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