Individual
SUSAN H LINDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,CFNP,CPNP
Contact information
Practice address
1483 TOBIAS GADSON BLVD, SUITE 102, CHARLESTON, SC 29407-8702
(843) 766-6229
(843) 766-2315
Mailing address
1483 TOBIAS GADSON BLVD, SUITE 102, CHARLESTON, SC 29407-8702
(843) 766-6229
(843) 766-2315
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2180
SC
363LP0200X
Pediatric Nurse Practitioner
2180
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197049
—
SC
Enumeration date
06/14/2006
Last updated
11/20/2007
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