Healthcare Provider Details

I. General information

NPI: 1710175179
Provider Name (Legal Business Name): SUSAN M FLICK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ALLEN BRADLEY DR STE 240
MAYFIELD HEIGHTS OH
44124-6130
US

IV. Provider business mailing address

300 ALLEN BRADLEY DR STE 240
MAYFIELD HEIGHTS OH
44124-6130
US

V. Phone/Fax

Practice location:
  • Phone: 216-382-8000
  • Fax: 216-297-3233
Mailing address:
  • Phone: 216-382-8000
  • Fax: 216-297-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number09704NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA.09704-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: