Provider Demographics
NPI:1134129331
Name:LAMB, SUSAN J (WHCNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:LAMB
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 N BRITAIN RD
Practice Address - Street 2:IRVING WOMEN'S HEALTH CENTER
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2630
Practice Address - Country:US
Practice Address - Phone:214-266-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX565033363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163776101Medicaid
TX163776104Medicaid
TX163776112Medicaid
TX163776106Medicaid
TX163776111Medicaid
TX163776109Medicaid
TX163776107Medicaid
TX163776110Medicaid
TX8N4793OtherBLUE CROSS BLUE SHIELD
TX163776108Medicaid
TX163776103Medicaid
TX163776105Medicaid