Individual
SUSANNE K. SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 824-3682
(270) 824-3675
Mailing address
PO BOX 1188, MADISONVILLE, KY 42431-5009
(270) 824-3682
(270) 824-3675
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
137090
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0563130
—
IA
05
—
0976845
—
IA
01
—
430079704
RAILROAD MEDICARE
—
01
—
80172
HEALTHCARE USA
MO
01
—
8298
HEALTHCARE USA (GROUP)
MO
05
—
915942007
—
MO
01
—
CG4336
RAILROAD MEDICARE
—
01
—
P00944104
MEDICARE RAILROAD FOR 5363
KY
Enumeration date
02/28/2007
Last updated
08/24/2011
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