Individual
MRS. SUSAN MARIE MALLONE-STEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4751 S CLEVELAND AVE, FORT MYERS, FL 33907-1317
(239) 343-9888
(239) 343-9868
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9888
(239) 343-9868
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN9395706
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN9395706
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013881500
—
FL
05
—
02136749
—
NY
Enumeration date
06/09/2005
Last updated
01/31/2022
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