Provider Demographics
NPI:1043338262
Name:MCGINNESS, SUSAN M (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:M
Last Name:MCGINNESS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:HOFFMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2663 IRMA LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:954-447-2704
Mailing Address - Fax:954-447-2708
Practice Address - Street 1:1951 SW 172ND AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5593
Practice Address - Country:US
Practice Address - Phone:954-447-2704
Practice Address - Fax:954-447-2708
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2041492363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3036529 00Medicaid