Individual
SUSAN V EBNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1418 E MAIN ST, STE 210, SANTA MARIA, CA 93454-4833
(805) 928-3678
(805) 928-6408
Mailing address
150 TEJAS PL, PO BOX 430, NIPOMO, CA 93444-9123
(805) 929-3211
(805) 929-6440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
279839
CA
164W00000X
Licensed Practical Nurse
Primary
1127
CA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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