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Individual
SUZANNE MARIE OBENRADER
Active
Individual
SUZANNE MARIE OBENRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN18636FL
PA
363L00000X
Nurse Practitioner
Primary
UP000800H
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30019410
KMHP
PA
01
—
574399
COVENTRY HEALTH AMERICA
PA
Enumeration date
12/06/2005
Last updated
11/08/2013
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