| Mrs Lisa Marie Suddreth, MSN, NP-C, PMHNP-BC | |
|
830 Summit Crossing Pl, Gastonia, NC 28054-2192 | |
| (704) 917-7610 | |
| (704) 917-7615 |
| Full Name | Mrs Lisa Marie Suddreth |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 830 Summit Crossing Pl, Gastonia, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033434519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 5004669 (North Carolina) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 5004669 (North Carolina) | Primary |
| Entity Name | Minuteclinic Diagnostic Of North Carolina Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699748608 PECOS PAC ID: 6002837572 Enrollment ID: O20051212000719 |
| Entity Name | Outreach Management Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417080680 PECOS PAC ID: 6800941923 Enrollment ID: O20171122000321 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Lisa Marie Suddreth, MSN, NP-C, PMHNP-BC 4089 Bordeaux Dr., Denver, NC 28037 Ph: (980) 434-8236 | Mrs Lisa Marie Suddreth, MSN, NP-C, PMHNP-BC 830 Summit Crossing Pl, Gastonia, NC 28054-2192 Ph: (704) 917-7610 |
Ieachia T. Morris, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1337 E Garrison Blvd, Gastonia, NC 28054 Phone: 704-671-5313 | |
Jonathan Labayo Desamero, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3715 Union Rd, Gastonia, NC 28056 Phone: 704-854-8202 | |
Susanna M Shepard, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 609 N Highland St, Gastonia, NC 28052 Phone: 704-853-5294 | |
Cecily Robin Smith, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 815 Cox Rd, Gastonia, NC 28054 Phone: 704-865-1700 Fax: 704-865-7948 | |
Sonya Nanette Belin, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3050 Riverwood Pkwy Ste B, Gastonia, NC 28056 Phone: 047-874-9005 | |
Mrs. Shannon Bumgardner Standish, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 920 Cox Rd Ste 201, Gastonia, NC 28054 Phone: 704-864-8302 Fax: 704-864-0228 | |
Nora Davis Paysour, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2525 Court Dr, Gastonia, NC 28054 Phone: 704-834-2000 Fax: 704-834-3274 |