Provider Demographics
NPI:1932473543
Name:HOWARD, SUSAN (RN, MSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:RN, MSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6414 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2316
Mailing Address - Country:US
Mailing Address - Phone:703-532-1254
Mailing Address - Fax:703-532-1254
Practice Address - Street 1:6414 SHADY LN
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2316
Practice Address - Country:US
Practice Address - Phone:703-532-1254
Practice Address - Fax:703-532-1254
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001149765163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant