Provider Demographics
NPI:1043370950
Name:KRASNER, SUSAN E (CNM, MS, ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:KRASNER
Suffix:
Gender:F
Credentials:CNM, MS, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E HOLLIS ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2928
Mailing Address - Country:US
Mailing Address - Phone:603-577-4300
Mailing Address - Fax:
Practice Address - Street 1:21 E HOLLIS ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2928
Practice Address - Country:US
Practice Address - Phone:603-477-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH055755-23-01367A00000X
MARN 169416-NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30346101Medicaid
NH000315101Medicare PIN