1285761429 NPI number — MRS. SUSAN JOY ALTERMATT FNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285761429 NPI number — MRS. SUSAN JOY ALTERMATT FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALTERMATT
Provider First Name:
SUSAN
Provider Middle Name:
JOY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OWEN ALTERMATT
Provider Other First Name:
SUSAN
Provider Other Middle Name:
JOY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285761429
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
145 PINELLAS LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAYNESVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28785-7273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-926-3849
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 FALCON CREST LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLYDE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28721-6620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-627-9998
Provider Business Practice Location Address Fax Number:
828-627-9946
Provider Enumeration Date:
02/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  82245 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)