Provider Demographics
NPI:1104014828
Name:LINDLEY, SUSAN E (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:LINDLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:E
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:408 CLIFFORD DR
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1012
Mailing Address - Country:US
Mailing Address - Phone:607-754-1028
Mailing Address - Fax:
Practice Address - Street 1:408 CLIFFORD DR
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1012
Practice Address - Country:US
Practice Address - Phone:607-754-1028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321950-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics