Provider Demographics
NPI:1790723849
Name:HSU, PAO-CHU (APRN)
Entity Type:Individual
Prefix:
First Name:PAO-CHU
Middle Name:
Last Name:HSU
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 1:33670 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2640
Mailing Address - Country:US
Mailing Address - Phone:813-915-5459
Mailing Address - Fax:727-221-5235
Practice Address - Street 1:33670 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2640
Practice Address - Country:US
Practice Address - Phone:813-915-5459
Practice Address - Fax:727-221-5235
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9168058363L00000X
FLARNP9168058363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY110GOtherBCBS
FL308279200Medicaid
FLY110GOtherBCBS
FL308279200Medicaid