Provider Demographics
NPI:1881815314
Name:CALDWELL, SUSAN MARIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MARIA
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177 ASHEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-3139
Mailing Address - Country:US
Mailing Address - Phone:828-452-6675
Mailing Address - Fax:828-452-6730
Practice Address - Street 1:2177 ASHEVILLE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3139
Practice Address - Country:US
Practice Address - Phone:828-452-6675
Practice Address - Fax:828-452-6730
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC144595163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse