Provider Demographics
NPI:1437338043
Name:HERMAN, SUSAN G (CRNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:G
Last Name:HERMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:G
Other - Last Name:FENSTERMACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2545 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7300
Practice Address - Country:US
Practice Address - Phone:484-884-9677
Practice Address - Fax:484-884-9297
Is Sole Proprietor?:No
Enumeration Date:2007-10-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN522026L163W00000X
PASP009674363LF0000X
NJ26NJ00172400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102082840Medicaid
PA007575OtherCRNP PRESCRIPTIVE AUTH
PARN522026LOtherREGISTERED NURSE LICENSE
PASP009674OtherCRNP LICENSE
PASP009674OtherCRNP LICENSE
PARN522026LOtherREGISTERED NURSE LICENSE