Provider Demographics
NPI:1407922883
Name:PAPE, SUSAN SOPER (RN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SOPER
Last Name:PAPE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6160 GREENBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17222-9678
Mailing Address - Country:US
Mailing Address - Phone:717-217-6824
Mailing Address - Fax:
Practice Address - Street 1:757 NORLAND AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4230
Practice Address - Country:US
Practice Address - Phone:717-217-6824
Practice Address - Fax:717-217-6942
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN334346L163WA2000X, 163WG0000X, 163WG0600X, 163WM0705X, 163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered163WG0600XNursing Service ProvidersRegistered NurseGerontology
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered163WR0400XNursing Service ProvidersRegistered NurseRehabilitation