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Individual
SUSAN MARIE SERGENT
Active
Individual
SUSAN MARIE SERGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA124
KY
363AM0700X
Medical Physician Assistant
PA124
KY
363AS0400X
Surgical Physician Assistant
PA124
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY124
LICENSE NUMBER
KY
Enumeration date
05/17/2007
Last updated
10/08/2024
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