Healthcare Provider Details

I. General information

NPI: 1568638203
Provider Name (Legal Business Name): CHRISTINE SUCHAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N MAIN ST SUTIE 306
AKRON OH
44310-3110
US

IV. Provider business mailing address

444 N MAIN ST SUTIE 306
AKRON OH
44310-3110
US

V. Phone/Fax

Practice location:
  • Phone: 330-379-5048
  • Fax: 330-253-2829
Mailing address:
  • Phone: 330-379-5048
  • Fax: 330-253-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number194924
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: