Basic Information
Provider Information
NPI: 1548612344
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESSING-SPILLER
FirstName: SUSAN
MiddleName: J.
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 HIGHLANDER POINT DR
Address2: SUITE 204
City: FLOYDS KNOBS
State: IN
PostalCode: 471199465
CountryCode: US
TelephoneNumber: 8125424921
FaxNumber: 8129495966
Practice Location
Address1: 1850 STATE ST
Address2:  
City: NEW ALBANY
State: IN
PostalCode: 471504990
CountryCode: US
TelephoneNumber: 8129447701
FaxNumber: 8129816505
Other Information
ProviderEnumerationDate: 07/06/2016
LastUpdateDate: 07/06/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X28169766AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home