Provider Demographics
NPI:1407913197
Name:CONATY-BUCK, SUSAN BETH (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:BETH
Last Name:CONATY-BUCK
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 S COLLEGE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1302
Mailing Address - Country:US
Mailing Address - Phone:302-831-3195
Mailing Address - Fax:302-831-3193
Practice Address - Street 1:540 S COLLEGE AVE STE 130
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-1302
Practice Address - Country:US
Practice Address - Phone:302-831-3195
Practice Address - Fax:302-831-3193
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2017-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE409475YNMMOtherMEDICARE, PTAN
VAQ16897Medicare UPIN