Provider Demographics
NPI:1205146586
Name:SUH, KAY BELK (FNPC)
Entity type:Individual
Prefix:MRS
First Name:KAY
Middle Name:BELK
Last Name:SUH
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 US 1 HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-7873
Mailing Address - Country:US
Mailing Address - Phone:252-536-5791
Mailing Address - Fax:252-536-5444
Practice Address - Street 1:100 W PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5923
Practice Address - Country:US
Practice Address - Phone:252-438-3549
Practice Address - Fax:252-438-2084
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004924363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004972Medicaid
NC2595151Medicare PIN
NCNCL312AMedicare PIN