| Doctor Name: | MRS. SUSAN FLOWERS FREDERICK |
| NPI Number: | 1043238587 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 2006004306 |
| Business Practice Address: | 152 Crossover Rd Beulaville, NC - 285188800 |
| Business Phone Number: | 9102984688 |
| Business Fax Number: | 9102984628 |
| Mailing Address: | 1850 W Arlington Blvd, GREENVILLE |
| State: | NC |
| Postal Code: | 278345704 |
| Phone Number: | 2524136740 |
| Fax Number: | 2527526600 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 05/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2006004306 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |