Individual provider · NPI-1

Mary Susan Shick, MSN, ANP

Nurse Practitioner, Adult Health · Bloomington, IN

NPI number1992733240
StatusActive
Last updated in NPPESDec 21, 2020

Details

NPI
1992733240
Entity type
Individual (NPI-1)
Name
Mary Susan Shick
Credential
MSN, ANP
Sex
Female
Sole proprietor
No
Enumeration date
Jun 28, 2006
Certification date
Dec 21, 2020
Last updated
Dec 21, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LA2200X Nurse Practitioner, Adult Health71000080AINYes
163WG0000X Registered Nurse, General Practice28090755AIN

Other names

  • Mary Susan Watts (Former Name)

Practice location

421 W 1st St
Bloomington, IN 47403-2403

Phone 812-336-0168 · Fax 812-335-7372

Mailing address

421 W 1st St
Bloomington, IN 47403-2403

Phone 812-336-0168 · Fax 812-335-7372

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Nurse Practitioner, Adult Health providers in Bloomington, IN