Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R073087 | MD |
N | 363LG0600X | Nurse Practitioner - Gerontology | R073087 | MD |
N | 363LP2300X | Nurse Practitioner - Primary Care | R073087 | MD |
NPI | 1003466715 |
---|---|
Provider Name | Susan Marie L'heureux |
First Address | Ellicott City, MD 21042-2418 |
Second Address | Ellicott City, MD 21042-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2019 |
Last Update Date | 14/09/2019 |