Provider Demographics
NPI:1659524890
Name:BARRETTE, SUSAN N (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:N
Last Name:BARRETTE
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 1:7077 N DIVISION ST RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-8037
Mailing Address - Country:US
Mailing Address - Phone:315-252-9367
Mailing Address - Fax:315-253-1156
Practice Address - Street 1:8 DILL ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3606
Practice Address - Country:US
Practice Address - Phone:315-253-1459
Practice Address - Fax:315-253-1156
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY254593-1163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator