Provider Demographics
NPI:1063515377
Name:EINSIEDL, SUZANNE MARIE (RN, MSN, PNP)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MARIE
Last Name:EINSIEDL
Suffix:
Gender:F
Credentials:RN, MSN, PNP
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:DODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, PNP
Mailing Address - Street 1:595 PRICE AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065
Mailing Address - Country:US
Mailing Address - Phone:650-367-4147
Mailing Address - Fax:650-369-0813
Practice Address - Street 1:595 PRICE AVE
Practice Address - Street 2:SUITE E
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065
Practice Address - Country:US
Practice Address - Phone:650-369-4147
Practice Address - Fax:650-369-0813
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 481536163W00000X
CA49673163WH0200X
CANP8537363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WH0200XNursing Service ProvidersRegistered NurseHome Health
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner