Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN.CNP.023200 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN.CNP.023200 | OH |
NPI | 1033683438 |
---|---|
Provider Name | Rita Susec |
First Address | Lorain, OH 44053-1652 |
Second Address | Lorain, OH 44053-1652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2019 |
Last Update Date | 24/07/2019 |