Provider Demographics
NPI:1629035027
Name:SUEHS, AUDREY LYNNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:LYNNE
Last Name:SUEHS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:AUDREY
Other - Middle Name:LYNNE
Other - Last Name:GETMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 PROVIDENCE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2203
Mailing Address - Country:US
Mailing Address - Phone:919-929-1375
Mailing Address - Fax:919-929-0711
Practice Address - Street 1:401 PROVIDENCE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2203
Practice Address - Country:US
Practice Address - Phone:919-929-1375
Practice Address - Fax:919-929-0711
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-07047363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPA0731Medicare ID - Type Unspecified
NYQ38273Medicare UPIN