Susada Inthavong
APRN | Nurse Practitioner
1504 Sullivan Ave, South Windsor
Connecticut, 06074-2711
860-644-1523
Susada Inthavong is a South Windsor, Connecticut based nurse practitioner. Active license number of Susada Inthavong is 003968 in Connecticut. Her current practice location is 1504 Sullivan Ave, South Windsor. Patients can reach her at 860-644-1523 or can fax her at 860-648-9468. Susada Inthavong is APRN and her NPI number (Unique professional ID assigned by NPPES) is 1275770398.
Susada Inthavong has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Susada Inthavong speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Susada Inthavong |
| Specialization: | Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | APRN |
| Practice Address: | 1504 Sullivan Ave, South Windsor,
Connecticut, 06074-2711 |
| Phone: | 860-644-1523 |
| Fax: | 860-648-9468 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1275770398 |
| NPI Enumeration Date: | 12 Jan, 2009 |
| NPI Last Update On: | 12 Jan, 2009 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Susada Inthavong are as mentioned below.
| License Number | Specialization | State | Status | |
| 003968 | | Connecticut | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Susada Inthavong such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 003968 | Other | Connecticut | STATE LICENSE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Susada Inthavong
29 Naek Rd, Suite 5
Vernon, Connecticut |
| Zip: | 06066-3942 |
| Phone Number: | 860-872-2289 |
| Fax Number: | 860-896-1425 |
Patients can reach Susada Inthavong at
1504 Sullivan Ave, South Windsor, Connecticut or can
call to book an appointment on 860-644-1523.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.