Individual
MRS. SUSAN MARY KIRWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD, MSN, CPNP-PC
Contact information
Practice address
7205 STONEHENGE DR, RALEIGH, NC 27613-1649
(919) 848-2249
Mailing address
50 MINERAL SPRING LN, FUQUAY VARINA, NC 27526-5734
(301) 785-4872
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
0024167791
VA
363LP0200X
Pediatric Nurse Practitioner
Primary
5009929
NC
363LP0200X
Pediatric Nurse Practitioner
579151
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447461314
—
NC
Enumeration date
05/24/2007
Last updated
04/29/2020
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