Healthcare Provider Details

I. General information

NPI: 1396950606
Provider Name (Legal Business Name): SUZANNE J. CHOINIERE MSN, RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST
DAYTON OH
45409-2722
US

IV. Provider business mailing address

218 LAKEVIEW DR
DAYTON OH
45459-4524
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-2563
  • Fax: 937-341-8428
Mailing address:
  • Phone: 937-434-2552
  • Fax: 937-341-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number111852
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberNS-03002
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: