Provider Demographics
NPI:1295816130
Name:SUESS, KIMBERLY A (PA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:A
Last Name:SUESS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:KIM
Other - Middle Name:A
Other - Last Name:SUESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:60 LIVINGSTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4402
Mailing Address - Country:US
Mailing Address - Phone:828-253-4851
Mailing Address - Fax:828-252-1969
Practice Address - Street 1:60 LIVINGSTON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4402
Practice Address - Country:US
Practice Address - Phone:828-253-4851
Practice Address - Fax:828-252-1969
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004797363AM0700X
NC001002096363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical