Provider Demographics
NPI:1932897691
Name:SUSWELL, DJANAH
Entity Type:Individual
Prefix:
First Name:DJANAH
Middle Name:
Last Name:SUSWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 PEACHTREE LN
Mailing Address - Street 2:
Mailing Address - City:WEST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3327
Mailing Address - Country:US
Mailing Address - Phone:215-687-7160
Mailing Address - Fax:
Practice Address - Street 1:1691 PEACHTREE LN
Practice Address - Street 2:
Practice Address - City:WEST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-3327
Practice Address - Country:US
Practice Address - Phone:215-687-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA72133601374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide