Provider Demographics
NPI:1144895350
Name:STEELE, SUSAN ELAINE (ADVANCED PRACTICE NP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELAINE
Last Name:STEELE
Suffix:
Gender:F
Credentials:ADVANCED PRACTICE NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1013 FERNWOOD DR STE C
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-5428
Mailing Address - Country:US
Mailing Address - Phone:478-295-0526
Mailing Address - Fax:478-295-3644
Practice Address - Street 1:1013 FERNWOOD DR STE C
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-5428
Practice Address - Country:US
Practice Address - Phone:478-295-0526
Practice Address - Fax:478-295-3644
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN187973363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health