Provider Demographics
NPI:1255522017
Name:PULEO, SUSAN ELLEN (RN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELLEN
Last Name:PULEO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7857 UMBERTO CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-2686
Mailing Address - Country:US
Mailing Address - Phone:239-793-2926
Mailing Address - Fax:239-793-2335
Practice Address - Street 1:5935 CORNERSTONE CT W
Practice Address - Street 2:#300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3737
Practice Address - Country:US
Practice Address - Phone:866-687-7390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9190053163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse