Provider Demographics
NPI:1790568566
Name:DANCY, SUSAN ANN (BSW, MPH, LALA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:DANCY
Suffix:
Gender:F
Credentials:BSW, MPH, LALA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6395 NC HIGHWAY 33 E
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-8964
Mailing Address - Country:US
Mailing Address - Phone:910-217-3030
Mailing Address - Fax:
Practice Address - Street 1:6395 NC HIGHWAY 33 E
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886-8964
Practice Address - Country:US
Practice Address - Phone:910-217-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility