Provider Demographics
NPI:1265483382
Name:BRYANT SUTTER, SUSAN ELIZABETH (NP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:BRYANT SUTTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 POND RD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2253
Mailing Address - Country:US
Mailing Address - Phone:610-395-4444
Mailing Address - Fax:
Practice Address - Street 1:1517 POND RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2253
Practice Address - Country:US
Practice Address - Phone:610-395-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003825D164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse