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General NPI Number Information
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NPI Number | 1205030400
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Entity Type | Individual
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Provider Name | SUSAN K LEGUIRE CNP
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Gender | Female
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 3700 KOLBE RD BEHAVIORAL HEALTH UNIT
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City | LORAIN
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State | OH
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Zip | 44053-1611
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Country | US
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Telephone | 440-960-4000
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Fax | 440-960-4017
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Provider Business Mailing Address
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Address Line | PO BOX 636643
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City | CINCINNATI
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State | OH
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Zip | 45263-6643
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Country | US
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Telephone | 440-960-4000
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Fax | 440-960-4017
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP09106
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License Number State | OH
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