Provider Demographics
NPI:1477685303
Name:HUNTINGTON, SUSAN RAE (ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:RAE
Last Name:HUNTINGTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-7907
Mailing Address - Country:US
Mailing Address - Phone:561-242-0505
Mailing Address - Fax:561-242-9883
Practice Address - Street 1:5205 VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-7907
Practice Address - Country:US
Practice Address - Phone:561-242-0505
Practice Address - Fax:561-242-9883
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2182322363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner