Provider Demographics
NPI:1093822850
Name:BROWN, SUSANNE E (RN, APRN-CNP)
Entity Type:Individual
Prefix:
First Name:SUSANNE
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN, APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7119 CHAMBERSBURG DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2908
Mailing Address - Country:US
Mailing Address - Phone:419-874-3578
Mailing Address - Fax:
Practice Address - Street 1:1730 S REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1402
Practice Address - Country:US
Practice Address - Phone:419-865-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-06678363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSHNP18701Medicare ID - Type Unspecified
OHQ48207Medicare UPIN