Provider Demographics
NPI:1437453685
Name:PRESTERA, SUSAN P (APN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:P
Last Name:PRESTERA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:PATRICIA
Other - Last Name:NIEHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:434-972-4266
Practice Address - Street 1:1215 LEE ST FL 2
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-243-1000
Practice Address - Fax:434-244-7551
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176505363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner