DR. SUSAN J VAN FOSSEN RN MSN BC PMHNP NPI 1558309328

NPI Information

NPI: 1558309328
Provider Name: DR. SUSAN J VAN FOSSEN, RN, MSN, BC, PMHNP,
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
616 W RUSSELL PL
SAN ANTONIO, TX
ZIP 78212
Phone: (800) 257-8715
Get Directions

DR. Susan J Van Fossen, RN, MSN, BC, PMHNP, is a psychiatric/mental health nurse practitioner in San Antonio, TX. DR. Susan J Van Fossen, RN, MSN, BC, PMHNP, NPI is 1558309328. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

616 W RUSSELL PL
SAN ANTONIO, TX
ZIP 78212-658
Phone: (800) 257-8715
Fax: (800) 819-1655

The NPI 1558309328 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/3/2006 and was last updated on 2/19/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	232874	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8N3327	OTHER	TEXAS	BLUE CROSS BLUE SHIELD
2	85N099	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
3	118282603	MEDICAID	TEXAS
4	118282605	OTHER	TEXAS	INDIVIDUAL
5	87N290	OTHER	TEXAS	BLUE CROSS BLUE SHIELD
6	83N731	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
7	85N013	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
8	118282602	MEDICAID	TEXAS
9	118282601	MEDICAID	TEXAS
10	500012787	OTHER	TEXAS	RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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