Provider Demographics
NPI:1306357066
Name:CONLEY, SUSAN EVONNE MCNATT (APRN, ACNS-BC, RN-BC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:EVONNE MCNATT
Last Name:CONLEY
Suffix:
Gender:F
Credentials:APRN, ACNS-BC, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4526 KENTON RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-0911
Mailing Address - Country:US
Mailing Address - Phone:302-222-3868
Mailing Address - Fax:
Practice Address - Street 1:640 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3530
Practice Address - Country:US
Practice Address - Phone:302-744-6579
Practice Address - Fax:302-744-6579
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-20
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0026123163W00000X
DEL9-0000116364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse