Provider Demographics
NPI:1639140718
Name:CAPPLEMAN, SUSAN DARLENE (DNP-CFNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DARLENE
Last Name:CAPPLEMAN
Suffix:
Gender:F
Credentials:DNP-CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 CITY AVE N
Mailing Address - Street 2:SUITE A
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-1414
Mailing Address - Country:US
Mailing Address - Phone:662-837-1404
Mailing Address - Fax:662-837-3760
Practice Address - Street 1:1009 CITY AVE N
Practice Address - Street 2:SUITE A
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-1414
Practice Address - Country:US
Practice Address - Phone:662-837-1404
Practice Address - Fax:662-837-3760
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR806851363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01021322Medicaid
MSQ14609Medicare UPIN
MS500001481Medicare ID - Type Unspecified