Provider Demographics
NPI:1043431976
Name:HANEY, SUSAN (FNP, MA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:HANEY
Suffix:
Gender:F
Credentials:FNP, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9429 TALISMAN DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3419
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2141 K ST NW
Practice Address - Street 2:SUITE 501
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1810
Practice Address - Country:US
Practice Address - Phone:202-994-6827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN26779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily