Individual
SUSAN LYN KRUSE-SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
230 W WASHINGTON SQ, PHILADELPHIA, PA 19106-3585
(215) 829-6088
Mailing address
230 W WASHINGTON SQ, PHILADELPHIA, PA 19106-3585
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN309947L
PA
363L00000X
Nurse Practitioner
Primary
SP014639
PA
Other
Enumeration date
12/02/2014
Last updated
08/11/2015
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