Susan K Conrad, ARNP
Individual provider Active NPI Nurse Practitioner · S. Pasadena, FL
NPI 1275739880 · NPPES record last updated Oct 11, 2012
Key facts
- NPI
- 1275739880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- ARNP739662 (FL)
- Practice address
- 1516 Pasadena Ave S.
#300
S. Pasadena, FL 33707-1223 - Phone
- (727) 490-3030
- Fax
- (727) 384-6167
- NPI assigned
- Jun 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP739662 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiology Consultants | Past | Accepting new patients | |
| West Florida Cardiology Network, LLC | Past |
Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/4692/brand/27/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP739662 | FL | Yes |
Addresses
Primary practice location
1516 Pasadena Ave S.
#300
S. Pasadena, FL 33707-1223
Mailing address
1615 Pasadena Ave S
Suite #300
S Pasadena, FL 33707-4516
Phone (727) 490-3030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ARNP 739662 | Other | FL | LICENSE |
Other providers in S. Pasadena, FL
All providers in S. Pasadena, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.