Individual
MRS. SHARON JORDAN SUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5453 DEERFIELD TRAIL, COLLEGE PARK, GA 30349-3173
(404) 587-0008
Mailing address
5453 DEERFIELD TRAIL, COLLEGE PARK, GA 30349-3173
(404) 587-0008
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0000008047
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0000008047
GA NURSE AIDE REGISTRY
GA
Enumeration date
11/15/2016
Last updated
11/15/2016
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