Provider Demographics
NPI:1225044704
Name:LELACHEUR, SUSAN FRANCES (PA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:FRANCES
Last Name:LELACHEUR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 16TH ST NW
Mailing Address - Street 2:#425
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1769
Mailing Address - Country:US
Mailing Address - Phone:202-994-6831
Mailing Address - Fax:
Practice Address - Street 1:1407 S ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3819
Practice Address - Country:US
Practice Address - Phone:202-745-6133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA11363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical