Provider Demographics
NPI:1194708784
Name:BARRON, SUZANNE D (NP)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:D
Last Name:BARRON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:390 S MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1766
Mailing Address - Country:US
Mailing Address - Phone:540-484-4836
Mailing Address - Fax:
Practice Address - Street 1:4348 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0720
Practice Address - Country:US
Practice Address - Phone:407-690-9755
Practice Address - Fax:540-772-8219
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024-094237363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10309867Medicaid
VA7793731Medicaid
VA7793731Medicaid
011461C47Medicare PIN
P79747Medicare UPIN
VA10309867Medicaid