Provider Demographics
NPI:1629159561
Name:MCCARTNEY, SUZANNE PATRICIA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:PATRICIA
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MRS
Other - First Name:SUZANNE
Other - Middle Name:PATRICIA
Other - Last Name:LACY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:101 OLDHAM PL
Mailing Address - Street 2:
Mailing Address - City:MAPLE GLEN
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2880
Mailing Address - Country:US
Mailing Address - Phone:215-317-6702
Mailing Address - Fax:
Practice Address - Street 1:101 OLDHAM PL
Practice Address - Street 2:
Practice Address - City:MAPLE GLEN
Practice Address - State:PA
Practice Address - Zip Code:19002-2880
Practice Address - Country:US
Practice Address - Phone:215-317-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN239308L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered