Peterson, Susan
Peterson, Susan is an sole proprietor health care provider with primary practice located at 18000 W 9 Mile Rd Ste 525 , Southfield MI 48075-4080. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Peterson, Susan can be contacted via phone (248) 327-6196.Contact Information
Primary practice address
18000 W 9 Mile Rd Ste 525
Southfield MI 48075-4080
Phone: (248) 327-6196
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 4704310011 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 4704310011 | Michigan |
Profile Details
| NPI number | 1134888118 |
|---|---|
| LBN Legal business name | Peterson, Susan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 16th, 2021 |
| Last updated | Apr 30th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134888118 | NPPES |
| Michigan | Other | 4704310011 | NURSING LICENSE NUMBER |
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