Susan Pham, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11002867 Issued in FL

Practice address

875 E Nine Mile Rd Ste 6
Pensacola, FL 32514-1708

Phone

(850) 542-7413

NPI assigned

Jul 2, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Redefyne- Skin & Body Revival

  • Clinic/Center
  • Pensacola, FL
  • NPI 1598560575
  NPD Authorized official
• Health and Hope Clinic, Inc.

  • Primary Care Clinic/Center
  • Pensacola, FL
  • NPI 1538318837
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1407418296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 E NINE MILE RD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141708",
            "telephone_number": "850-542-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E NINE MILE RD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141708",
            "telephone_number": "850-542-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11002867",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Colleen Pfeiler, MSN, APRN, FNP-C
• Christine Pham, MD
• Kerry Jo Pham, ARNP, CNM
• Minh Cong Pham, M.D.
• Paul V Pham, PHARM D
• Thu-Kim Phan, PHARMD, BCOP
• Pharmacist Formulations LLC
• Joshua L Phelps
• Mary Kathryn Phelps
• Phyllis L Phelps, ARNP

• Family Nurse Practitioner in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.