MEDICARE: MRS. SUSAN M RAO NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	NP-15693	OH

General Provider Information

NPI Number	:	1437552692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN M RAO NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1270 FAIRWAY VIEW LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45233-4700
Country	:	US
Telephone Number	:	513-389-9155
Fax Number	:

Provider Business Practice Location Address
First Line	:	1270 FAIRWAY VIEW LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45233-4700
Country	:	US
Telephone Number	:	513-389-9155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2014
Last Update Date	:	03/22/2017

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