Provider Demographics
NPI:1033184320
Name:KIHLMIRE, SUSAN H (APRN,BC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:H
Last Name:KIHLMIRE
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 NEW SHACKLE ISLAND ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2481
Mailing Address - Country:US
Mailing Address - Phone:615-824-4244
Mailing Address - Fax:615-824-5916
Practice Address - Street 1:264 NEW SHACKLE ISLAND ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2481
Practice Address - Country:US
Practice Address - Phone:615-824-4244
Practice Address - Fax:615-824-5916
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN91664163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3346715Medicaid
TN103I501899Medicare PIN
TNS65948Medicare UPIN