Healthcare Provider Details

I. General information

NPI: 1649921123
Provider Name (Legal Business Name): SANDRA SUITER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2022
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 N HIGH ST
HILLSBORO OH
45133-8692
US

IV. Provider business mailing address

120 W MAIN ST
CIRCLEVILLE OH
43113-1654
US

V. Phone/Fax

Practice location:
  • Phone: 740-529-2125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0031591
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number296873
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3017937
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: