Healthcare Provider Details

I. General information

NPI: 1356761100
Provider Name (Legal Business Name): SUZI YEE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2014
Last Update Date: 11/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 S 15TH ST
COSHOCTON OH
43812-2285
US

IV. Provider business mailing address

406 S 15TH ST
COSHOCTON OH
43812-2285
US

V. Phone/Fax

Practice location:
  • Phone: 740-295-3331
  • Fax: 740-295-3332
Mailing address:
  • Phone: 740-295-3331
  • Fax: 740-295-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.388155
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.15889-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: