Individual
MS. SUSAN LYNN KUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
612 MOCKSVILLE AVE, SALISBURY, NC 28144-2732
(704) 210-5661
(704) 210-5660
Mailing address
165 LAKE PINE RD, MOORESVILLE, NC 28117-7476
(704) 663-7928
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
32363
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430044436
RR MEDICARE
NC
05
—
8050224
—
NC
Enumeration date
07/02/2006
Last updated
10/28/2020
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