Provider Demographics
NPI:1821322140
Name:CARRINGTON, SUSAN R (PNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:R
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 GOLDEN BEAR LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-8951
Mailing Address - Country:US
Mailing Address - Phone:318-617-2948
Mailing Address - Fax:
Practice Address - Street 1:303 S HIGHWAY 78 STE 106
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-3915
Practice Address - Country:US
Practice Address - Phone:972-433-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX760812363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX392182702Medicaid
TX382182702Medicaid