Individual
MRS. SUSAN JANE PONIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ANP
Contact information
Practice address
602 IVY ST FL 2, ELMIRA, NY 14905-1646
(607) 737-4333
(607) 737-4271
Mailing address
709 N JUSTICE ST, STE A, HENDERSONVILLE, NC 28791-3455
(828) 697-7377
(828) 697-7380
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
304914
NY
363L00000X
Nurse Practitioner
Primary
5015271
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04652273
—
NY
Enumeration date
07/01/2008
Last updated
11/11/2021
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