Provider Demographics
NPI:1346233244
Name:METZGER, SUSAN E (CRNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:METZGER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 KENHORST BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1716
Mailing Address - Country:US
Mailing Address - Phone:610-775-7133
Mailing Address - Fax:610-775-8658
Practice Address - Street 1:530 KENHORST BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1716
Practice Address - Country:US
Practice Address - Phone:610-775-7133
Practice Address - Fax:610-775-8658
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP001782G363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAME381531OtherHIGHMARK BLUE SHIELD
PA50079139OtherCAPITAL BLUE CROSS
PA013835Medicare ID - Type Unspecified