Healthcare Provider Details

I. General information

NPI: 1609395425
Provider Name (Legal Business Name): PATRICIA L SUTTER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 E ELM ST
UNION CITY OH
45390-1722
US

IV. Provider business mailing address

835 SWEITZER ST
GREENVILLE OH
45331-1077
US

V. Phone/Fax

Practice location:
  • Phone: 937-968-7416
  • Fax: 937-968-3026
Mailing address:
  • Phone: 937-569-6996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.021797
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: