Provider Demographics
NPI:1730312919
Name:STOREY, SUSAN CAROL (APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:CAROL
Last Name:STOREY
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Gender:F
Credentials:APRN, BC
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Mailing Address - Street 1:310 EISENHOWER DR
Mailing Address - Street 2:BLDG 5
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2632
Mailing Address - Country:US
Mailing Address - Phone:912-692-1451
Mailing Address - Fax:912-350-3980
Practice Address - Street 1:310 EISENHOWER DR
Practice Address - Street 2:BLDG 5
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2632
Practice Address - Country:US
Practice Address - Phone:912-692-1451
Practice Address - Fax:912-350-3980
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN060668 NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health