Smith, Susan Spivock
Smith, Susan Spivock is an sole proprietor health care provider with primary practice located at 100 Brewster Blvd Naval Hospital, Camp Lejeune NC 28548-2538. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Smith, Susan Spivock can be contacted via phone (910) 450-4159.Contact Information
Primary practice address
100 Brewster Blvd Naval Hospital
Camp Lejeune NC 28548-2538
Phone: (910) 450-4159
Fax: (910) 450-4194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | R108147 | Maryland |
Profile Details
| NPI number | 1336144252 |
|---|---|
| LBN Legal business name | Smith, Susan Spivock |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Oct 25th, 2011 - about 15 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 | 1336144252 | NPPES |
| Maryland | MEDICAID | 553211600 |
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