Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | SP007734 | PA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP007734 | PA |
NPI | 1023152626 |
---|---|
Provider Name | Susan Mary Ott |
First Address | Pittsburgh, PA 15224-1722 |
Second Address | Pittsburgh, PA 15224-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103188610 | (05) | PA |