Provider Demographics
NPI:1023168176
Name:NAWROCK, SUZANNE F (NP)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:F
Last Name:NAWROCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PENNS TRL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1812
Mailing Address - Country:US
Mailing Address - Phone:215-504-1761
Mailing Address - Fax:215-504-1721
Practice Address - Street 1:3 PENNS TRL
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-504-1761
Practice Address - Fax:215-504-1721
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12344363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0194395Medicaid
CAP65794Medicare UPIN
NJ0194395Medicaid
P65794Medicare UPIN
NJ152987Medicare PIN