Provider Demographics
NPI:1952573057
Name:MCNAUL, SUSAN JOYCE (RN MSN CFNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JOYCE
Last Name:MCNAUL
Suffix:
Gender:F
Credentials:RN MSN CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1101 EXCHANGE PL APT 1425
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4206
Mailing Address - Country:US
Mailing Address - Phone:315-854-2668
Mailing Address - Fax:
Practice Address - Street 1:1101 EXCHANGE PL APT 1425
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4206
Practice Address - Country:US
Practice Address - Phone:315-854-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335870363LF0000X
NC5013197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVKNNP26612Medicare PIN
WVKNNP26611Medicare PIN