Provider Demographics
NPI:1023267028
Name:HEALY, SUSAN (MSN, CFNP, LNC, CDE)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HEALY
Suffix:
Gender:F
Credentials:MSN, CFNP, LNC, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 ABBOTT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4483
Mailing Address - Country:US
Mailing Address - Phone:831-649-1000
Mailing Address - Fax:831-649-4962
Practice Address - Street 1:355 ABBOTT ST STE 200
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4483
Practice Address - Country:US
Practice Address - Phone:831-422-3636
Practice Address - Fax:831-422-1255
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP5905363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner