Provider Demographics
NPI:1689089054
Name:FREWERT, SUSAN (APRN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:FREWERT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KINGS RANSOM LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5847
Mailing Address - Country:US
Mailing Address - Phone:603-669-5556
Mailing Address - Fax:
Practice Address - Street 1:4 KINGS RANSOM LN
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5847
Practice Address - Country:US
Practice Address - Phone:603-669-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH040323-23363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health