Provider Demographics
NPI:1336432269
Name:WALKFORD, SUSANNE M (ANP)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:M
Last Name:WALKFORD
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:SUSANNE
Other - Middle Name:M
Other - Last Name:STRIETZEL, KACHLIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7250 PARKWAY DR STE 500
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1343
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:
Practice Address - Street 1:7250 PARKWAY DR STE 500
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1343
Practice Address - Country:US
Practice Address - Phone:443-949-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELP-0000201363LA2200X
MDR255550363LA2200X
NMR67460363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health