Individual
MS. SUSAN JANE MAHLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
277 WATERMAN STREET, PROVIDENCE, RI 02906
(401) 331-7777
(401) 354-4445
Mailing address
98 LOCKWOOD STREET, WEST WARWICK, RI 02893
(401) 821-0787
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NPP37228
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312543
BLUE CROSS BLUE SHIELD
RI
05
—
SM59428
—
RI
Enumeration date
01/08/2007
Last updated
10/28/2008
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