Provider Demographics
NPI:1043756349
Name:SLUSSER, KATHERINE BLAKE (LCCE, FACCE)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:BLAKE
Last Name:SLUSSER
Suffix:
Gender:F
Credentials:LCCE, FACCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3197
Mailing Address - Street 2:
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560-3197
Mailing Address - Country:US
Mailing Address - Phone:804-761-8008
Mailing Address - Fax:
Practice Address - Street 1:807 WAKEFIELD AVE
Practice Address - Street 2:
Practice Address - City:TAPPAHANNOCK
Practice Address - State:VA
Practice Address - Zip Code:22560
Practice Address - Country:US
Practice Address - Phone:804-761-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula