Provider Demographics
NPI:1871761890
Name:LAJOIE, SUSAN NICHOLSON (ARNP, MSN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:NICHOLSON
Last Name:LAJOIE
Suffix:
Gender:F
Credentials:ARNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 DR. LASALLE LEFFALL DR.
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351
Mailing Address - Country:US
Mailing Address - Phone:850-539-2888
Mailing Address - Fax:850-539-2766
Practice Address - Street 1:278 DR. LASALLE LEFFALL DR.
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351
Practice Address - Country:US
Practice Address - Phone:850-539-2888
Practice Address - Fax:850-539-2766
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1568462363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool