Doctor Name: | MRS. SUE ELLYN NOTTINGHAM |
NPI Number: | 1891853644 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 71000515 |
Business Practice Address: | 400 Pilgrim Blvd Hartford City, IN - 473481382 |
Business Phone Number: | 7653485776 |
Business Fax Number: | 7653483088 |
Mailing Address: | 400 Pilgrim Blvd, HARTFORD CITY |
State: | IN |
Postal Code: | 473481382 |
Phone Number: | 7653482254 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2006 |
NPI Last Update Date: | 06/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71000515 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |