Provider Demographics
NPI:1396519427
Name:KNOTTS, SUZANNA (BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:SUZANNA
Middle Name:
Last Name:KNOTTS
Suffix:
Gender:F
Credentials:BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 TUXWARD RD
Mailing Address - Street 2:
Mailing Address - City:HARTLY
Mailing Address - State:DE
Mailing Address - Zip Code:19953-1922
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 E CAMDEN WYOMING AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-1303
Practice Address - Country:US
Practice Address - Phone:302-550-9802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL-308187163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant