Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP2980002 | FL |
NPI | 1053424945 |
---|---|
Provider Name | Ms. Susan S Bingham |
First Address | Riverview, FL 33579-7182 |
Second Address | Tampa, FL 33619-4215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 26/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
305059900 | (05) | FL |
P26904 | (02) |