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NPI Code Detail

MEDICARE: SUSAN MARIE KASPERCZYK CNP

MEDICARE: SUSAN MARIE KASPERCZYK CNP
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.16949OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700150216
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MARIE KASPERCZYK CNP
Provider Business Mailing Address
First Line : 262 W MAIN ST
Second Line :
City : AMELIA
State : OH
Zip : 45102-1309
Country : US
Telephone Number : 513-718-2260
Fax Number :
Provider Business Practice Location Address
First Line : 262 W MAIN ST
Second Line :
City : AMELIA
State : OH
Zip : 45102-1309
Country : US
Telephone Number : 513-718-2260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2012
Last Update Date : 05/30/2025

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