MEDICARE: MS. SUSAN L DUNCAN NP

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	363L00000X	Nurse Practitioner	APN11580	TN
2	363LA2200X	Adult Health Nurse Practitioner	APN0000011580	TN
3	363LA2200X	Adult Health Nurse Practitioner	RN087544-AP05778	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3B019D628	OTHER	LA	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407834732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN L DUNCAN NP

Provider Business Mailing Address
First Line	:	423 LAKEVIEW AVE
Second Line	:
City	:	MCCOMB
State	:	MS
Zip	:	39648-2807
Country	:	US
Telephone Number	:	225-289-1167
Fax Number	:

Provider Business Practice Location Address
First Line	:	7900 MS-570
Second Line	:
City	:	SUMMIT
State	:	MS
Zip	:	39666
Country	:	US
Telephone Number	:	601-684-7771
Fax Number	:

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/28/2015

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