Individual
SUSAN DISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 HOSPITAL LN, STE 110, DANVILLE, IN 46122-2600
(765) 762-4170
Mailing address
112 HOSPITAL LN, STE 110, DANVILLE, IN 46122-2600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
71005869A
IN
363LF0000X
Family Nurse Practitioner
71005869A
IN
Other
Enumeration date
11/16/2015
Last updated
01/04/2023
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