Provider Demographics
NPI:1649457433
Name:KAUSMEYER, SUSAN ANN NICHOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SUSAN ANN
Middle Name:NICHOLE
Last Name:KAUSMEYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 OVERLOOK DRIVE
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640
Mailing Address - Country:US
Mailing Address - Phone:570-655-1911
Mailing Address - Fax:570-655-1472
Practice Address - Street 1:225 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-1058
Practice Address - Country:US
Practice Address - Phone:570-655-1911
Practice Address - Fax:570-655-1472
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist