Individual
SUSANNE MARIE PASSERETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1000 W MORENO ST, PENSACOLA, FL 32501-2316
(850) 494-8024
Mailing address
1121 NESTLING CT, GULF BREEZE, FL 32563-2637
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1793542
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3055922-00
—
FL
01
—
590-88943
ALABAMA BLUE CROSS BLUE SHIELD
—
01
—
P00131636
RAILROAD MEDICARE
—
01
—
Y026W
FLORIDA BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/22/2005
Last updated
01/03/2010
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