Provider Demographics
NPI:1548259195
Name:KIER-MERRIHEW, SUSAN (NP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KIER-MERRIHEW
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 1:25 DEGRANDPRE WAY
Mailing Address - Street 2:ASSOCIATES IN OBGYN, PC
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-6449
Mailing Address - Country:US
Mailing Address - Phone:518-563-3260
Mailing Address - Fax:518-561-2877
Practice Address - Street 1:25 DEGRANDPRE WAY
Practice Address - Street 2:ASSOCIATES IN OBGYN, PC
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-563-3260
Practice Address - Fax:518-561-2877
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0001081363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1899871OtherGHI
NY321801OtherMVP
NY000405790002OtherBSNENY
BB1771Medicare ID - Type Unspecified
NY000405790002OtherBSNENY