Provider Demographics
NPI:1639118250
Name:MIESNIK, SUSAN RUMPF (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:RUMPF
Last Name:MIESNIK
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 WHEATFIELD LN
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1845
Mailing Address - Country:US
Mailing Address - Phone:215-343-7182
Mailing Address - Fax:
Practice Address - Street 1:324 S 34TH ST
Practice Address - Street 2:WOOD BUILDING, ROOM 5135
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4304
Practice Address - Country:US
Practice Address - Phone:215-590-5925
Practice Address - Fax:215-590-2447
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP003971T363LP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal