Provider Demographics
NPI:1538391842
Name:ATTMORE, SUSAN M (APRN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:ATTMORE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 CAPITAL BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3576
Mailing Address - Country:US
Mailing Address - Phone:860-614-7518
Mailing Address - Fax:877-836-3540
Practice Address - Street 1:400 CAPITAL BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-3576
Practice Address - Country:US
Practice Address - Phone:860-614-7518
Practice Address - Fax:877-836-3540
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT4192363LA2200X
CT86728163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse