Provider Demographics
NPI:1912305681
Name:CARR, SUZANNE NOELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:NOELLE
Last Name:CARR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:NOELLE
Other - Last Name:NORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 KNOX COURT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036
Mailing Address - Country:US
Mailing Address - Phone:704-892-5454
Mailing Address - Fax:
Practice Address - Street 1:104 KNOX COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036
Practice Address - Country:US
Practice Address - Phone:704-892-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-12
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007371363LF0000X
CO0000795363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily