Provider Demographics
NPI:1437156551
Name:CELDRAN, SUZANNE M (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:M
Last Name:CELDRAN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 FARMDALE RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1321
Mailing Address - Country:US
Mailing Address - Phone:304-529-7004
Mailing Address - Fax:304-529-7303
Practice Address - Street 1:6475 FARMDALE RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1321
Practice Address - Country:US
Practice Address - Phone:304-529-7004
Practice Address - Fax:304-529-7303
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV44204363L00000X
WVAPRN44204-FNP-BC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV96002757000Medicaid
WVP00093065OtherTRAVELERS RAILROAD MCR
WV001721286OtherBLUE CROSS / BLUE SHIELD OF WV
OH2315328Medicaid
WVP00093065OtherTRAVELERS RAILROAD MCR
OHCENP01853Medicare PIN
WV001721286OtherBLUE CROSS / BLUE SHIELD OF WV
WVCENP01851Medicare PIN