MEDICARE: SUZANNE KAHLE APRN

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	363LP2300X	Primary Care Nurse Practitioner	026308	OH
2	163W00000X	Registered Nurse	403713	OH

General Provider Information

NPI Number	:	1750847216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE KAHLE APRN

Provider Business Mailing Address
First Line	:	2239 SUSSEX AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-1401
Country	:	US
Telephone Number	:	513-582-6547
Fax Number	:

Provider Business Practice Location Address
First Line	:	3908 MIAMI RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-3705
Country	:	US
Telephone Number	:	513-760-5511
Fax Number	:	513-781-9600

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

Provider Enumeration Date	:	02/20/2019
Last Update Date	:	02/11/2020

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