Susan Hostetter, NP
Individual provider Active NPI Pediatric Nurse Practitioner · Exeter, CA
NPI 1205971108 · NPPES record last updated Sep 27, 2011
Key facts
- NPI
- 1205971108
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- NP12347 (CA)
- Practice address
- 216 E. Pine Street
Exeter, CA 93221-1750 - Phone
- (559) 562-2600
- Fax
- (559) 562-2610
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241122001256 | CA | Practitioner - Nurse Practitioner | 7719412162 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP12347 | CA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Physicians Network | Current |
Accepting new patients | |
| Adventist Health Physicians Network | Current |
Accepting new patients | |
| Visalia Medical Clinic, Inc. | Current | Accepting new patients | |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| Family Healthcare Network | Past | Accepting new patients |
Locations
1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695
Interoperability endpoints
- susanhostetter@vmchealth.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | NP12347 | CA | Yes |
Addresses
Primary practice location
216 E. Pine Street
Exeter, CA 93221-1750
Mailing address
PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725
Other providers in Exeter, CA
- Robin H Heyde-McCoy
- Ann E. Hickey
- Lisa Higgins
- Marcella J Hojnacki
- Brandi Holmes
- Torey Sue Ivanic
- Lauren M Ivanoff
- Roberto Jaramillo
- Marlaine Cheryl Jensen
- Corey J Jones
All providers in Exeter, CA · Pediatric Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.