MEDICARE: SUSAN L SEARS

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	163W00000X	Registered Nurse	1071441	KY
2	363L00000X	Nurse Practitioner	2603P	KY

General Provider Information

NPI Number	:	1093927212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN L SEARS

Provider Business Mailing Address
First Line	:	214 BOGGS LN
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2522
Country	:	US
Telephone Number	:	859-228-2048
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 ACE DR
Second Line	:
City	:	BEREA
State	:	KY
Zip	:	40403-1327
Country	:	US
Telephone Number	:	859-228-2048
Fax Number	:

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/10/2010

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Directions to “ SUSAN L SEARS ” Practice Location

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