Provider Demographics
NPI:1619374055
Name:WEBB, SUZANNE DAVIS (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:DAVIS
Last Name:WEBB
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9925 HAYNES BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8532
Mailing Address - Country:US
Mailing Address - Phone:770-777-7495
Mailing Address - Fax:
Practice Address - Street 1:9925 HAYNES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8532
Practice Address - Country:US
Practice Address - Phone:770-777-7495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN240704363LW0102X
SC18763363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health