Provider Demographics
NPI:1669537494
Name:CHENG, SU-CHING (FNP)
Entity type:Individual
Prefix:MRS
First Name:SU-CHING
Middle Name:
Last Name:CHENG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-973-7000
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:5721 CUTLER HEALTH CTR
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04469-5721
Practice Address - Country:US
Practice Address - Phone:207-581-4000
Practice Address - Fax:207-581-9513
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER037845363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MER037845OtherSTATE LICENSE