Provider Demographics
NPI:1124404256
Name:EAKIN, SUSANNE M (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:M
Last Name:EAKIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:SUSANNE
Other - Middle Name:M
Other - Last Name:HASLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2821 WOODLAWN AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1423
Mailing Address - Country:US
Mailing Address - Phone:330-479-2375
Mailing Address - Fax:
Practice Address - Street 1:2821 WOODLAWN AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1423
Practice Address - Country:US
Practice Address - Phone:330-479-7450
Practice Address - Fax:330-479-7452
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF06151384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily