Provider Demographics
NPI:1538399837
Name:O'ROURKE, SUZANNE T (NP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:T
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:T
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:101 SPICERVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:EATON RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:48827
Mailing Address - Country:US
Mailing Address - Phone:517-663-2705
Mailing Address - Fax:517-663-9470
Practice Address - Street 1:101 SPICERVILLE HWY
Practice Address - Street 2:
Practice Address - City:EATON RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:48827
Practice Address - Country:US
Practice Address - Phone:517-663-2705
Practice Address - Fax:517-663-9470
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704173726363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily