Doctor Name: | MISS SUSAN YVONNE PRIDGEN |
NPI Number: | 1306809959 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.T.C.-L |
License Number: | |
Business Practice Address: | 8409 Leesville Rd Raleigh, NC - 276131004 |
Business Phone Number: | 9198704273 |
Business Fax Number: | |
Mailing Address: | 8308 Amber Lantern St, Apt 302 RALEIGH |
State: | NC |
Postal Code: | 276134580 |
Phone Number: | 9192471213 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |