Provider Demographics
NPI:1487797460
Name:HULET, SUSAN L (CPM)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:HULET
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 LETA LN
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-3124
Mailing Address - Country:US
Mailing Address - Phone:817-808-4170
Mailing Address - Fax:817-488-7977
Practice Address - Street 1:608 LETA LN
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3124
Practice Address - Country:US
Practice Address - Phone:817-808-4170
Practice Address - Fax:817-488-7977
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96138176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX96138OtherLICENSED MIDWIFE NUMBER
TX98010028OtherNARM CERTIFICATION