Provider Demographics
NPI:1558838565
Name:SENKO, SUSAN MARIE (DNP, AGNP-BC, APRN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:SENKO
Suffix:
Gender:F
Credentials:DNP, AGNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 LITTLE CURRENT DR APT 4023
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4622
Mailing Address - Country:US
Mailing Address - Phone:732-814-1054
Mailing Address - Fax:
Practice Address - Street 1:2440 LITTLE CURRENT DR APT 4023
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-4622
Practice Address - Country:US
Practice Address - Phone:732-814-1054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-28
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176809363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner