Healthcare Provider Details

I. General information

NPI: 1407997455
Provider Name (Legal Business Name): SUZANNE MARIE COADY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HEIDELBERG MEDDAC
APO AE
09042
DE

IV. Provider business mailing address

GIESSENER STR 6
HEPPENHEIM HESSEN
64646
DE

V. Phone/Fax

Practice location:
  • Phone: 3804045
  • Fax:
Mailing address:
  • Phone: 496252795093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number706312
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: