Provider Demographics
NPI:1033122171
Name:SKUKALEK, SUSANA LIBHABER (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:LIBHABER
Last Name:SKUKALEK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:SUSANA
Other - Middle Name:
Other - Last Name:LIBHABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:845 DREWRY ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3718
Mailing Address - Country:US
Mailing Address - Phone:404-931-3757
Mailing Address - Fax:404-778-5121
Practice Address - Street 1:THE EMORY CLINIC DEPT OF NEUROSURGERY 1365B CLIFTON RD
Practice Address - Street 2:SUITE 2200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-778-5770
Practice Address - Fax:404-778-5121
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN144854363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health