Provider Demographics
NPI:1013343342
Name:FOLK, SUSAN RENEE (NP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:RENEE
Last Name:FOLK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ANTHONY AVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8089
Mailing Address - Country:US
Mailing Address - Phone:207-544-8411
Mailing Address - Fax:207-888-1044
Practice Address - Street 1:108 ANTHONY AVE
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8089
Practice Address - Country:US
Practice Address - Phone:207-544-8411
Practice Address - Fax:207-888-1044
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN53492363LF0000X
MECNP131045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2549Medicaid
NC1013343342Medicaid
NC5006461OtherBOARD OF NURSING
NCNCF207AMedicare PIN