Retzlaff Deitrick, Susan K
Retzlaff Deitrick, Susan K is an individual health care provider with primary practice located at 418 N Webb Rd , Grand Island NE 68803-4045. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Retzlaff Deitrick, Susan K can be contacted via phone (308) 382-1100.Contact Information
Primary practice address
418 N Webb Rd
Grand Island NE 68803-4045
Phone: (308) 382-1100
Fax: (308) 385-0796
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 829 | Nebraska |
Profile Details
| NPI number | 1912907981 |
|---|---|
| LBN Legal business name | Retzlaff Deitrick, Susan K |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Feb 14th, 2020 - about 6 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 | 1912907981 | NPPES |
| Nebraska | Other | 37315 | BCBS OF NE |
| Nebraska | MEDICAID | 100250168 | BCBS OF NE |
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