Provider Demographics
NPI:1164977757
Name:SUITER, LUCHINDA (LPN)
Entity Type:Individual
Prefix:
First Name:LUCHINDA
Middle Name:
Last Name:SUITER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 S VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-5021
Mailing Address - Country:US
Mailing Address - Phone:931-703-8859
Mailing Address - Fax:
Practice Address - Street 1:615 WILSON AVE
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3264
Practice Address - Country:US
Practice Address - Phone:931-455-9369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN79720164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse