Provider Demographics
NPI:1831473776
Name:EASLEY, SUSANNE EDWARDS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:EDWARDS
Last Name:EASLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 8TH STREET DR NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2354
Mailing Address - Country:US
Mailing Address - Phone:828-322-9249
Mailing Address - Fax:
Practice Address - Street 1:3123 PLATEAU RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-8900
Practice Address - Country:US
Practice Address - Phone:704-276-1078
Practice Address - Fax:704-274-1079
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist