Provider Demographics
NPI:1093734709
Name:ELDERS, SUSAN HEALY (RN, BSN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:HEALY
Last Name:ELDERS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11985 HERITAGE OAK PL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2461
Mailing Address - Country:US
Mailing Address - Phone:530-886-1387
Mailing Address - Fax:530-886-1334
Practice Address - Street 1:11985 HERITAGE OAK PL
Practice Address - Street 2:SUITE 1
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2461
Practice Address - Country:US
Practice Address - Phone:530-886-1387
Practice Address - Fax:530-886-1334
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236698163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health