Provider Demographics
NPI:1881858074
Name:CLYMER, SUSAN JONES (NP)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:JONES
Last Name:CLYMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:95 COLLIER ROAD NW
Mailing Address - Street 2:SUITE 2035
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-605-2800
Mailing Address - Fax:404-351-5983
Practice Address - Street 1:275 COLLIER RD NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1709
Practice Address - Country:US
Practice Address - Phone:404-605-2800
Practice Address - Fax:404-351-5983
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA113899363LF0000X
GARN113899207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA979226746A, B. DMedicaid
GA979226746A, B. DMedicaid