Provider Demographics
NPI:1770502957
Name:NAVERSEN, SUSAN G (AP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:G
Last Name:NAVERSEN
Suffix:
Gender:F
Credentials:AP
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Mailing Address - Street 1:8 TOURNAMENT BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6842
Mailing Address - Country:US
Mailing Address - Phone:561-308-2528
Mailing Address - Fax:561-494-0984
Practice Address - Street 1:321 NORTHLAKE BLVD
Practice Address - Street 2:STE 102
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5422
Practice Address - Country:US
Practice Address - Phone:561-494-0866
Practice Address - Fax:561-494-0984
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAP1530171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist