Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APN.1440RX | SC |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | LC####### | CA |
NPI | 1275697625 |
---|---|
Provider Name | Ms. Susan Evelyn Collins-Joerger |
First Address | Greenville, SC 29607-1738 |
Second Address | Greenville, SC 29615-4812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 22/04/2015 |