Basic Information
| Provider Information | |||||||||
| NPI: | 1023378676 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OMROD | ||||||||
| FirstName: | SUZANNE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MSN, RN, ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 209 GROUSE TRL | ||||||||
| Address2: | |||||||||
| City: | WYOMING | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199349540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027308353 | ||||||||
| FaxNumber: | 8773838544 | ||||||||
| Practice Location | |||||||||
| Address1: | 4051 OGLETOWN RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197133159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023963023 | ||||||||
| FaxNumber: | 8773838544 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2012 | ||||||||
| LastUpdateDate: | 05/16/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | LB-0000256 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.