Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 93-00259 | NC |
NPI | 1033158258 |
---|---|
Provider Name | Suzanne Hamilton Nutt |
First Address | Gastonia, NC 28054-4725 |
Second Address | Gastonia, NC 28054-4725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 01/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8963430 | (05) | NC |
F75141 | (02) | NC |