Susan Abdullah, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R865352 Issued in MS

Practice address

902 Highway 27 N
Tylertown, MS 39667-7906

Phone

(601) 876-0204

Fax

(601) 213-4880

NPI assigned

Jan 24, 2011

Last updated

Jan 24, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Gautreaux Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1992000939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 HIGHWAY 27 N",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396677906",
            "telephone_number": "601-876-0204",
            "fax_number": "601-213-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 HIGHWAY 27 N",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396677906",
            "telephone_number": "601-876-0204",
            "fax_number": "601-213-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULLAH",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "R865352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "GAUTREAUX",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Registered Nurse in Tylertown, MS
• Providers in Tylertown, MS by specialty
• Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.