Provider Demographics
NPI:1316552110
Name:PINSON, SUSAN ASHLEY PARKER (FNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ASHLEY PARKER
Last Name:PINSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 SAINT CLAIR DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-3225
Mailing Address - Country:US
Mailing Address - Phone:229-402-0541
Mailing Address - Fax:
Practice Address - Street 1:126 US HIGHWAY 280 W
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31719-8645
Practice Address - Country:US
Practice Address - Phone:229-924-6011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN195321363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner