Provider Demographics
NPI:1790515575
Name:BEIER, SUSANNAH JOY (APRN)
Entity type:Individual
Prefix:
First Name:SUSANNAH
Middle Name:JOY
Last Name:BEIER
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E PINE ST STE 110
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2759
Mailing Address - Country:US
Mailing Address - Phone:850-603-2882
Mailing Address - Fax:574-406-7347
Practice Address - Street 1:100 E PINE ST STE 110
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2759
Practice Address - Country:US
Practice Address - Phone:850-603-2882
Practice Address - Fax:574-406-7347
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034684363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health