Provider Demographics
NPI:1760192199
Name:GOODE, SUZANNA HUNTER (LNP)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:HUNTER
Last Name:GOODE
Suffix:
Gender:F
Credentials:LNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8764 MATOAKA GLEN RD
Mailing Address - Street 2:
Mailing Address - City:QUINTON
Mailing Address - State:VA
Mailing Address - Zip Code:23141-1393
Mailing Address - Country:US
Mailing Address - Phone:804-929-8255
Mailing Address - Fax:
Practice Address - Street 1:8770 MATOAKA GLEN RD
Practice Address - Street 2:
Practice Address - City:QUINTON
Practice Address - State:VA
Practice Address - Zip Code:23141-1393
Practice Address - Country:US
Practice Address - Phone:804-929-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily