Basic Information
| Provider Information | |||||||||
| NPI: | 1427080795 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | ARNP MSN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 S FLOYD ST | ||||||||
| Address2: | SUITE 804 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025830127 | ||||||||
| FaxNumber: | 5025831239 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 S FLOYD ST | ||||||||
| Address2: | SUITE 804 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025830127 | ||||||||
| FaxNumber: | 5025831239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 363LN0000X | 1074035 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal |
No ID Information.