Provider Demographics
NPI:1588631303
Name:CAREY, SUSAN W (APRN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:W
Last Name:CAREY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 INDIAN HILLS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4029
Mailing Address - Country:US
Mailing Address - Phone:402-397-7057
Mailing Address - Fax:
Practice Address - Street 1:8901 INDIAN HILLS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4029
Practice Address - Country:US
Practice Address - Phone:402-397-7057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110345363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025280000Medicaid
NE10025280000Medicaid
NE098021019Medicare PIN
NE279312Medicare ID - Type Unspecified
NES92426Medicare UPIN