Provider Demographics
NPI:1811225261
Name:MUELLER, SUSAN K (APRN, CNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:MUELLER
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:K
Other - Last Name:BRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:661 S PEACE RD
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-1642
Mailing Address - Country:US
Mailing Address - Phone:815-991-3571
Mailing Address - Fax:815-991-3572
Practice Address - Street 1:661 S PEACE RD
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-1642
Practice Address - Country:US
Practice Address - Phone:815-991-3571
Practice Address - Fax:815-991-3571
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997036-NP363L00000X
IL209007903363L00000X
IL277000841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner