Provider Demographics
NPI:1538275714
Name:TWINING, SUSAN JANE (NP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JANE
Last Name:TWINING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 MORSE AVE
Mailing Address - Street 2:OCCUPATIONAL MEDICINE
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2135
Mailing Address - Country:US
Mailing Address - Phone:916-973-7766
Mailing Address - Fax:916-973-7739
Practice Address - Street 1:2016 MORSE AVE
Practice Address - Street 2:OCCUPATIONAL MEDICINE
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2135
Practice Address - Country:US
Practice Address - Phone:916-973-7766
Practice Address - Fax:916-973-7739
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN293403363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP17580Medicare UPIN
CAZZZ19156ZMedicare PIN