Individual
SUSAN OTREMBA
Active
Individual
SUSAN OTREMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R133788
MD
363LA2100X
Acute Care Nurse Practitioner
Primary
R133788
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419030100
—
MD
01
—
960533-01
BLUE CROSS/BLUE SHIELD
MD
01
—
S062-0374
BLUE CROSS REGIONAL
MD
Enumeration date
05/23/2007
Last updated
08/28/2024
Update your record
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