Provider Demographics
NPI:1245663038
Name:RUNGE, SUZANNE ELIZABETH (NP-C)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ELIZABETH
Last Name:RUNGE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-6381
Mailing Address - Country:US
Mailing Address - Phone:772-742-9270
Mailing Address - Fax:855-531-6012
Practice Address - Street 1:3255 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-6381
Practice Address - Country:US
Practice Address - Phone:772-742-9270
Practice Address - Fax:855-531-6012
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9263514363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily