Provider Demographics
NPI:1164110813
Name:SKARSTEN, SUZANNE ELIZABETH
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:SKARSTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2293 FAYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:VT
Mailing Address - Zip Code:05065-6551
Mailing Address - Country:US
Mailing Address - Phone:802-380-2490
Mailing Address - Fax:
Practice Address - Street 1:2293 FAYBROOK RD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:VT
Practice Address - Zip Code:05065-6551
Practice Address - Country:US
Practice Address - Phone:802-380-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH063564-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse