Provider Demographics
NPI:1679249718
Name:KASOZI, SUSAN BABIRYE (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BABIRYE
Last Name:KASOZI
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 1:97 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2524
Mailing Address - Country:US
Mailing Address - Phone:857-312-6804
Mailing Address - Fax:
Practice Address - Street 1:97 CONANT ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2524
Practice Address - Country:US
Practice Address - Phone:857-312-6804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2293882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty