Kleckley, Suzan M

Kleckley, Suzan M is an individual health care provider with primary practice located at 3815 Faber Place Dr , North Charleston SC 29405-8533. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kleckley, Suzan M can be contacted via phone (843) 767-9312.

Contact Information

Primary practice address
3815 Faber Place Dr North Charleston SC 29405-8533
Fax: (843) 767-9313
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN2502 South Carolina

Profile Details

NPI number 1649247685
LBN Legal business name Kleckley, Suzan M
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Feb 27th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649247685 NPPES
South Carolina MEDICAID NP0782
South Carolina MEDICAID GP2517

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