Individual
SUSAN A SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3701 MARKET ST, 6TH FLOOR SUITE 640, PHILADELPHIA, PA 19104-5502
(215) 662-2250
Mailing address
3624 MARKET ST, SUITE 560W, PHILADELPHIA, PA 19104-2614
(215) 662-2286
(215) 615-0500
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
VP002019C
PA
Other
Enumeration date
11/28/2006
Last updated
07/26/2007
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