Provider Demographics
NPI:1528072055
Name:CARR, SUSAN (CRNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 3217
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2067
Mailing Address - Country:US
Mailing Address - Phone:302-623-4242
Mailing Address - Fax:302-623-4241
Practice Address - Street 1:4745 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 3217
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2067
Practice Address - Country:US
Practice Address - Phone:302-623-4242
Practice Address - Fax:302-623-4241
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP003990T363L00000X
DEAPN-0001492363LP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner