Provider Demographics
NPI:1821027046
Name:SUVLU, CHRISTY H (WHNP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:H
Last Name:SUVLU
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:HYDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:262 HARLOW ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4952
Mailing Address - Country:US
Mailing Address - Phone:207-973-3649
Mailing Address - Fax:
Practice Address - Street 1:262 HARLOW ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4952
Practice Address - Country:US
Practice Address - Phone:207-973-3649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER034093363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK394OtherLICENSE-NP
AK8545OtherLICENSE-RN
AK8545OtherLICENSE-RN