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Individual

SUSAN R GASQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
14821 DAYTON PIKE, STE B, SALE CREEK, TN 37373-5752
(423) 497-5070
Mailing address
30 BURTON HILLS BLVD, STE 175, NASHVILLE, TN 37215-6403
(615) 988-2014
(615) 208-1303

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1083187
AL
363L00000X
Nurse Practitioner
Primary
12850
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1326373861
GROUP NPI
AL
Enumeration date
09/25/2006
Last updated
11/11/2021
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