Provider Demographics
NPI:1801485925
Name:HOUSTON, SUSAN ELIZABETH (DNP, AGNP-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:DNP, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 STANTONSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2800
Mailing Address - Country:US
Mailing Address - Phone:252-847-9908
Mailing Address - Fax:
Practice Address - Street 1:2610 STANTONSBURG RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2800
Practice Address - Country:US
Practice Address - Phone:252-847-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC181968163WC0400X
NC5015086363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management