Mahlke, Susan Jane

Mahlke, Susan Jane is an individual health care provider with primary practice located at 277 Waterman Street , Providence RI 02906. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Mahlke, Susan Jane can be contacted via phone (401) 331-7777.

Contact Information

Primary practice address
277 Waterman Street Providence RI 02906
Phone: (401) 331-7777
Fax: (401) 354-4445
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X NPP37228 Rhode Island

Profile Details

NPI number 1720137151
LBN Legal business name Mahlke, Susan Jane
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Oct 28th, 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 1720137151 NPPES
Rhode Island Other 312543 BLUE CROSS BLUE SHIELD
Rhode Island MEDICAID SM59428 BLUE CROSS BLUE SHIELD

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