Provider Demographics
NPI:1447556691
Name:FOCKLER, SUE (NURSE PRAC)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:
Last Name:FOCKLER
Suffix:
Gender:F
Credentials:NURSE PRAC
Other - Prefix:MS
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:116 NYON RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-7045
Mailing Address - Country:US
Mailing Address - Phone:910-340-6627
Mailing Address - Fax:910-353-1536
Practice Address - Street 1:317 WESTERN BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6338
Practice Address - Country:US
Practice Address - Phone:910-340-6627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79054363LN0005X
NC930134363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care