Provider Demographics
NPI:1629218524
Name:ONCU, SUSAN M (CRNA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:ONCU
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:G
Other - Last Name:MCCARTNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 HUNTERS PT
Mailing Address - Street 2:
Mailing Address - City:NELLYSFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22958-8097
Mailing Address - Country:US
Mailing Address - Phone:757-561-4593
Mailing Address - Fax:
Practice Address - Street 1:126 HUNTERS PT
Practice Address - Street 2:
Practice Address - City:NELLYSFORD
Practice Address - State:VA
Practice Address - Zip Code:22958-8097
Practice Address - Country:US
Practice Address - Phone:757-561-4593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001141887367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1629218524Medicaid