Provider Demographics
NPI:1891426383
Name:TSU-THAI, SUSAN (DNP,RN,CRNP,FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:TSU-THAI
Suffix:
Gender:F
Credentials:DNP,RN,CRNP,FNP-BC
Other - Prefix:MISS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:TSU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6403 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5919
Mailing Address - Country:US
Mailing Address - Phone:410-608-2384
Mailing Address - Fax:
Practice Address - Street 1:6403 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5919
Practice Address - Country:US
Practice Address - Phone:410-608-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR135099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily