Provider Demographics
NPI:1891093928
Name:SAUNDERS, SUSAN CAROL (LPN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CAROL
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-1845
Mailing Address - Country:US
Mailing Address - Phone:518-681-4501
Mailing Address - Fax:
Practice Address - Street 1:2 CLARK ST
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-1845
Practice Address - Country:US
Practice Address - Phone:518-681-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133597-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse