Provider Demographics
NPI:1265584304
Name:SINGALEWITCH, SUSAN RENE (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:RENE
Last Name:SINGALEWITCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 CHAMPIONS PATH
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-2560
Mailing Address - Country:US
Mailing Address - Phone:757-218-6020
Mailing Address - Fax:
Practice Address - Street 1:MCDONALD ARMY HEALTH CENTER
Practice Address - Street 2:576 JEFFERSON AVE
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604-5548
Practice Address - Country:US
Practice Address - Phone:757-961-6579
Practice Address - Fax:757-961-6593
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001140676163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse