Individual
SUSAN R FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6998 CRIDER RD STE 120, MARS, PA 16046-2390
(724) 742-3820
(724) 742-3838
Mailing address
6998 CRIDER RD STE 120, MARS, PA 16046-2390
(724) 742-3820
(724) 742-3838
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
TP004402Y
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102380028
—
PA
Enumeration date
07/29/2005
Last updated
01/25/2017
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