Provider Demographics
NPI:1114452141
Name:SCHLOSS, SUSAN V (CPNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:V
Last Name:SCHLOSS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:DIANE
Other - Last Name:VAN SLYKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:3960 VIRGINIA BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2449
Mailing Address - Country:US
Mailing Address - Phone:757-668-4648
Mailing Address - Fax:757-668-4944
Practice Address - Street 1:3960 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2449
Practice Address - Country:US
Practice Address - Phone:757-668-4648
Practice Address - Fax:757-668-4944
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166201363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics