Individual
SUSANNAH COOPER SPERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
110 HO PLZ, ITHACA, NY 14853-3102
(607) 255-5155
Mailing address
110 HO PLZ, ITHACA, NY 14853-3102
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
217929
AZ
163W00000X
Registered Nurse
790555
NY
163W00000X
Registered Nurse
RN-89507
NM
163WG0000X
General Practice Registered Nurse
225421
TN
363L00000X
Nurse Practitioner
Primary
F347658
NY
363LF0000X
Family Nurse Practitioner
217929
AZ
Other
Enumeration date
10/01/2018
Last updated
07/02/2021
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