Provider Demographics
NPI:1033683438
Name:SUSEC, RITA (CNP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:SUSEC
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:
Other - Last Name:BARTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3600 KOLBE RD STE 11
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1652
Mailing Address - Country:US
Mailing Address - Phone:440-222-4003
Mailing Address - Fax:440-960-4922
Practice Address - Street 1:3600 KOLBE RD STE 11
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1652
Practice Address - Country:US
Practice Address - Phone:440-222-4003
Practice Address - Fax:440-960-4922
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023200363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology