| NPI | 1770659369 |
|---|---|
| Former Name | SUSAN MARIE PENDERGAST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10022479) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP10281) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 78919) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SD CP003124) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR 227670) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP115768) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WY 53781) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OK 207061) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2025-04-02 |