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Individual
SUSAN DIRKS
Active
Individual
SUSAN DIRKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
201757
MA
363LG0600X
Gerontology Nurse Practitioner
201757
MA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
201757
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP2443
BC/BS PROVIDER NUMBER
MA
Enumeration date
06/01/2006
Last updated
12/09/2015
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