Provider Demographics
NPI:1700903044
Name:ECKLUND, SUSAN M (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:ECKLUND
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:M
Other - Last Name:SOLDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN-FNP
Mailing Address - Street 1:1022 DOLLYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PIGEON FORGE
Mailing Address - State:TN
Mailing Address - Zip Code:37863-4113
Mailing Address - Country:US
Mailing Address - Phone:865-868-1333
Mailing Address - Fax:865-868-1307
Practice Address - Street 1:1022 DOLLYWOOD LN
Practice Address - Street 2:
Practice Address - City:PIGEON FORGE
Practice Address - State:TN
Practice Address - Zip Code:37863-4113
Practice Address - Country:US
Practice Address - Phone:865-868-1333
Practice Address - Fax:865-868-1307
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN20055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily