Provider Demographics
NPI:1598034886
Name:ELDRIDGE, SUSAN WOOLLEN (PNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:WOOLLEN
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:WOOLLEN
Other - Last Name:FIGUEROA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:7494 BATTLEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-7306
Mailing Address - Country:US
Mailing Address - Phone:706-935-5437
Mailing Address - Fax:706-935-3004
Practice Address - Street 1:7494 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-7306
Practice Address - Country:US
Practice Address - Phone:706-935-5437
Practice Address - Fax:706-935-3004
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA228752363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care