Doctor Name: | MS. SUSAN S BINGHAM |
NPI Number: | 1053424945 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | ARNP2980002 |
Business Practice Address: | 508 N Maryland Ave Plant City, FL - 335633820 |
Business Phone Number: | 8133497600 |
Business Fax Number: | 8133497661 |
Mailing Address: | 13110 Elk Mountain Dr, RIVERVIEW |
State: | FL |
Postal Code: | 335797182 |
Phone Number: | 8133497568 |
Fax Number: | 8133497561 |
NPI Enumeration Date: | 08/16/2006 |
NPI Last Update Date: | 11/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | ARNP2980002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |