Provider Demographics
NPI:1649583030
Name:WARD, SUZANNE HEBERT (RN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:HEBERT
Last Name:WARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28875 PERDIDO BEACH BLVD
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-3354
Mailing Address - Country:US
Mailing Address - Phone:251-975-8047
Mailing Address - Fax:251-974-3233
Practice Address - Street 1:28875 PERDIDO BEACH BLVD
Practice Address - Street 2:UNIT 1B
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-3354
Practice Address - Country:US
Practice Address - Phone:251-975-8047
Practice Address - Fax:251-974-3233
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-107297163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse