Provider Demographics
NPI:1023378676
Name:OMROD, SUZANNE E (MSN, RN, ANP-BC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:E
Last Name:OMROD
Suffix:
Gender:F
Credentials:MSN, RN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17068 LANKFORD HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:EASTVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23347
Mailing Address - Country:US
Mailing Address - Phone:573-311-0867
Mailing Address - Fax:
Practice Address - Street 1:17068 LANKFORD HIGHWAY
Practice Address - Street 2:
Practice Address - City:EASTVILLE
Practice Address - State:VA
Practice Address - Zip Code:23347
Practice Address - Country:US
Practice Address - Phone:757-331-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELB-0000256363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health