Individual
SUSAN K FABRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
27383
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2308363
—
OH
05
—
7102194000
—
WV
05
—
78009610
—
KY
Enumeration date
04/14/2006
Last updated
09/26/2012
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