National Provider Identifier

Susan Jane Ponivas, RN, ANP

Susan Jane Ponivas, RN, ANP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Elmira, NY and a listed phone number of (607) 737-4333.

NPI 1467614230Elmira, NYNurse Practitioner

Profile Overview

NPI
1467614230
Provider Type
Individual
Primary Specialty
Nurse Practitioner
Enumeration Date
July 01, 2008
Last Updated
November 11, 2021

Practice Location

  • 602 Ivy St Fl 2
  • Elmira, NY 14905-1646

Phone: (607) 737-4333

Mailing Address

  • 709 N Justice St
  • Ste A
  • Hendersonville, NC 28791-3455

Specialties

  • Nurse Practitioner (363L00000X)
  • Nurse Practitioner (363L00000X)
Full Record
NPI
1467614230
Entity Type
Individual
Last Name
Ponivas
First Name
Susan
Middle Name
Jane
Name Prefix
Mrs.
Credential
RN, ANP
Mailing Street Address
709 N Justice St
Mailing Address Line 2
Ste A
Mailing City
Hendersonville
Mailing State
NC
Mailing ZIP Code
28791-3455
Mailing Country
US
Mailing Phone
(828) 697-7377
Mailing Fax
(828) 697-7380
Practice Street Address
602 Ivy St Fl 2
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14905-1646
Practice Country
US
Practice Phone
(607) 737-4333
Practice Fax
(607) 737-4271
Enumeration Date
July 01, 2008
Last Updated
November 11, 2021
Sex
Female
Sole Proprietor
No
Certification Date
November 11, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Nurse Practitioner (363L00000X), Nurse Practitioner (363L00000X)
Other Identifiers
04652273 (NY)