Provider Demographics
NPI:1487157947
Name:CLAPP, SUSAN B (AGNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:B
Last Name:CLAPP
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 STONEY RIDGE BLVD APT 302
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-4993
Mailing Address - Country:US
Mailing Address - Phone:434-841-4529
Mailing Address - Fax:
Practice Address - Street 1:COMMUNITY ACCESS NETWORK
Practice Address - Street 2:800 5TH STREET
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504-2450
Practice Address - Country:US
Practice Address - Phone:434-200-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1487157947363LP0808X
VA24175922363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty