Provider Demographics
NPI:1568689172
Name:STOKES, SUZANNE B (MSN, CNS)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:B
Last Name:STOKES
Suffix:
Gender:F
Credentials:MSN, CNS
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:B
Other - Last Name:WALDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, CNS
Mailing Address - Street 1:613 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-4011
Mailing Address - Country:US
Mailing Address - Phone:252-315-6547
Mailing Address - Fax:
Practice Address - Street 1:505 N SPENCE AVE STE F
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4292
Practice Address - Country:US
Practice Address - Phone:919-778-8551
Practice Address - Fax:919-778-8552
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC80793163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6004024Medicaid