Healthcare Provider Details

I. General information

NPI: 1346154572
Provider Name (Legal Business Name): SUSI WEBBER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 AUSTIN AVE NW
MASSILLON OH
44646-3554
US

IV. Provider business mailing address

8941 SHOEMAKER AVE NW
CANAL FULTON OH
44614-9367
US

V. Phone/Fax

Practice location:
  • Phone: 330-832-8100
  • Fax:
Mailing address:
  • Phone: 330-234-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN.094099
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: