MEDICARE: SUZANNE A FLOTTEMESCH ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11380	OH

General Provider Information

NPI Number	:	1750494241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE A FLOTTEMESCH ARNP

Provider Business Mailing Address
First Line	:	4440 RED BANK RD
Second Line	:	SUITE 110
City	:	CINCINNATI
State	:	OH
Zip	:	45227-2176
Country	:	US
Telephone Number	:	513-564-1366
Fax Number	:	513-564-1367

Provider Business Practice Location Address
First Line	:	4440 RED BANK RD
Second Line	:	SUITE 110
City	:	CINCINNATI
State	:	OH
Zip	:	45227-2176
Country	:	US
Telephone Number	:	513-564-1366
Fax Number	:	513-564-1367

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	12/04/2015

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