MEDICARE: SUSAN ERKENBRACK PLATT APRN, FNP-BC

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	242852	NC
2	363L00000X	Nurse Practitioner	5005143	NC

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	:	1528288222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN ERKENBRACK PLATT APRN, FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 602373
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-2373
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1388 SAND HILL RD
Second Line	:	MISSION MY CARE PLUS CANDLER
City	:	CANDLER
State	:	NC
Zip	:	28715-8937
Country	:	US
Telephone Number	:	828-213-5335
Fax Number	:	828-213-5336

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

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	10/26/2015

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